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cardioverter-defibrillator (ICD) helps protect you against dangerous heart
rhythms. It's important to know how this device works and how to keep it
working right. Learning a few important facts about ICDs can
help you get the best results from your device.
You may have a device that combines an ICD with a pacemaker, which keeps your heart from beating too slowly. To learn more about pacemakers, see Heart Problems: Living With a Pacemaker.
When you have an ICD, it's important to avoid strong magnetic
and electrical fields. The lists below show some electrical and magnetic sources and
how they may affect your ICD. For best results, follow these
guidelines. These safety tips also apply to devices that combine an ICD and a pacemaker. If you have questions, check with your doctor.
Your doctor or the manufacturer of your ICD can give you a full list of things that you need to avoid and
things that are safe to use.
Stay away from:
Use with caution:
Safe to use:
If you get a shock from your ICD, follow the plan you set up with your doctor. In general, your plan depends on how you feel after you get a shock and how many times you get a shock.
After one shock:
After a second shock within 24 hours:
Most medical tests and procedures won't affect your ICD,
except for MRI, which uses strong magnets. To be safe:
You can travel safely with a cardiac device. But you'll want to be prepared before you go.
If you have an arrhythmia or an ICD that makes it dangerous for you to drive, your doctor might suggest that you stop driving, at least for a short time. You probably don't have to stop or limit driving if your arrhythmia doesn't cause bad symptoms.
To learn more, see Heart Rhythm Problems and Driving.
If you think you have an infection near your device, call your doctor right away. Signs of an infection include:
Ask your doctor what sort of activity and intensity is safe for you. ICDs are set to shock at a specific heart rate.
So your target heart rate during exercise will probably be at least 10 to 15
beats below the ICD discharge heart rate.
You doctor can help you learn how to use a rating of perceived exertion (RPE) as a way to tell how hard you are exercising. This can help you keep your heart rate at a safe level during exercise.
Stop exercising and call your doctor if you have:
Most people who have an ICD (implantable cardioverter-defibrillator) can have an active sex life. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.
After you get the device implanted, you'll let your chest heal for a short time before resuming sex. If you or your partner is worried about resuming sex, talk with your doctor about your concerns. Your doctor or another health professional can give you support and advice.
What if I get shocked? Many people with ICDs worry that the ICD might shock them during sex. The risk of getting a shock during sex seems to be the same as during any other similar level of exercise. If you get a shock during sex, you will follow your plan about when to call your doctor.
Will my partner get shocked? Some people worry that if they get shocked during sex, their partner might be hurt. But your partner will not be shocked or feel any pain if you get shocked.
You may feel nervous about living with an ICD, and you may worry about getting shocked.
The shock can be uncomfortable. It may feel like you are being kicked in the chest. For many people, getting a shock can cause anxiety and depression.
It's common to be worried about living with an ICD. After all, you don't know when a shock might occur, and a shock could be a reminder that your heart is not as healthy as it could be. But if you take a few simple steps, you can feel better about having an ICD.
As you plan for your future and your end of life, include plans for your ICD. You can make the decision to turn off your ICD as part of the medical treatment you want at the end of life. You can put this information in your advance directive.
Other Works Consulted
Lampert R, et al. (2010). HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. Heart Rhythm, 7(7): 1008–1026. Available online: http://www.hrsonline.org/Policy/ClinicalGuidelines/upload/ceids_mgmt_eol.pdf.
Sears SF, et al. (2005). How to respond to an implantable cardioverter-defibrillator shock. Circulation, 111(23): e380–e382.
Vasquez LD, et al. (2010). Sexual health for patients with an implantable cardioverter-defibrillator. Circulation, 122(13): e465–e467.
Wilkoff BL, et al. (2008). HRS/EHRA expert consensus
on the monitoring of cardiovascular implantable electronic devices (CIEDS):
Description of techniques, indications, personnel, frequency, and ethical
considerations. Heart Rhythm, 5(6): 907–925. Available
November 4, 2013
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
& Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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