Defibrillators Living With a Defibrillator

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After cardiac arrest, surgery to implant an ICD, or a fitting for a WCD, you will need regular visits with your healthcare provider to check your condition, the device, or any medicines you are taking. You can get an ID card with information about your device to keep with you. It can be helpful in an emergency, to show airport security, or for medical personnel who need to know more about your device. If you have an ICD, be aware of the signs of complications that may occur.

It takes time to get used to having an ICD or WCD. These devices can deliver electrical energy at different strengths to regulate your heart.

• The low-energy electrical shocks your device gives are not painful. You may not notice them, or you may feel a fluttering in your chest.
• High-energy shocks last only a fraction of a second, but they can be strong or painful. They may feel like thumping or a kick in the chest, depending on their strength. Before a shock, you may feel symptoms of arrhythmia. If you feel one or two strong shocks over a short period and the symptoms go away, it may be a sign that the device is working. Notify your provider and set up an appointment that day or the next day. He or she will want to assess your condition and the device.
• Unnecessary shocks may be delivered when they are not needed during the adjustment period after your surgery. A damaged wire or a very fast heart rate due to extreme physical activity may trigger unnecessary shocks. These shocks can also occur if you forget to take your medicines. Some people also feel phantom shocks, even when the device does not detect an arrhythmia.

Read about how ICDs work.

You will wear your WCD all the time, except when you are taking a shower or bath. Like shocks from ICDs, shocks from WCDs can be painful and sometimes cause burns. Your doctor will explain how to charge and change the batteries in your WCD.

Talk to your provider about when you can return to normal activities, such as physical activity and driving.

• Physical activity is usually not limited when you have an ICD. This includes sports and exercise, including strenuous activities. You may need to avoid full-contact sports, such as football. Contact sports can damage your ICD or shake loose the wires in your heart. Ask your provider how much and what types of physical activity are safe for you.
• Driving can probably be resumed according to your typical patterns after you recover from surgery. However, if you received an ICD to prevent another cardiac arrest or ventricular arrhythmia, it will probably be several months before your provider says you are ready to drive again. This is because of the risks of fainting or getting a shock from your device. Your provider may also suggest driving restrictions based on the activity recorded by your device.

Once you have an ICD, you will visit your provider at least every six months.

At the follow-up visits, your doctor may take these steps:

• Prescribe or adjust your medicines to lower the number of irregular heartbeats you have. Fewer irregular beats will mean fewer high-energy shocks that have to be sent to your heart.
• Check to make sure the device continues to work properly and that it has not shifted in your body or caused irritation or injury. Over time, your ICD may stop working well because its wires get dislodged or broken, its battery fails, your heart disease progresses, or other devices have disrupted its electrical signaling. Your doctor also may recommend an electrocardiogram (EKG) to check for changes in your heart’s electrical activity.
• Check to see whether you are at risk of heart failure. If device and medicine adjustments do not reduce your irregular heart rhythms, your doctor may suggest a procedure called ablation to stop excess electrical signals in your heart.
• Check to see whether the battery needs to be replaced. Batteries in ICDs last between five and seven years. When the batteries in your device run down, you will need surgery to replace them. Replacing the battery is less involved than the original surgery to implant the ICD. Ask your doctor whether the device generator or its wires need to be replaced, too.

Electrical devices and devices with strong magnetic fields can interfere with your ICD. You may not be able to feel when this happens. If something disrupts your ICD, step away from the disruptive device to help restore your ICD’s normal working. To be safe, keep your ICD at least six inches away from cell phones and headphones, or, when necessary, use them only briefly.

• If you have an ICD on the left side of your chest, hold your cell phone to your right ear.
• Most headphones have a magnetic element in them. Wear them as far away from your ICD as possible, and do not carry your headphones in a chest pocket.
• The risk of harm is low from metal detectors, such as those used for airport security, but you can show your ID card and ask for alternative inspection.

Some medical procedures, including magnetic resonance imaging (MRI), can damage ICDs. This depends on the procedure and your device model. For example, some people with newer models can undergo MRI. Tell your dentist or doctor that you have an ICD and discuss your options with them. You can show them the card with information about your device.

It is possible for a wire in an ICD to fire at the wrong time or become infected. Call your provider if you have symptoms that concern you, and if you have these symptoms in particular:

• Fainting
• Dizziness or feeling out of breath
• Fever
• Heart palpitations or chest pain

Go to a hospital emergency room if you feel many strong shocks from your device in a short time.

Occasionally an ICD does not work properly and cannot be fixed with changes in programming or medicine. If this happens, your doctor might have to replace the ICD. When you visit your provider, ask whether the manufacturer has announced any problems with your device.

If you have survived cardiac arrest, you may worry about whether it will happen again. After surgery to implant an ICD or after a fitting for a WCD, adjusting to the uncertainty of life with the device may cause fear, anxiety, and stress. When your device sends a strong shock, it may startle or distress you or cause you pain. This can make some people stop doing the things they used to do. After having cardiac arrest or getting an ICD, some people report anxiety, depression, or other more serious emotional health concerns.

If you are living with an ICD or WCD and experience anxiety or depression, tell your doctor about your concerns.