Because of their capabilities, ICDs have become standard treatment for anyone who has survived cardiac arrest and are used increasingly in individuals who are at high risk of sudden cardiac arrest. If you have an ICD, your risk of sudden death from cardiac arrest is significantly lower than it would be if you were treated only with medications to correct your heartbeat.
If you're at high risk of ventricular tachycardia and ventricular fibrillation, an ICD may be your best defense against cardiac arrest. Once you have an ICD, it's likely you'll need to keep it for life. Although the electrical shocks may be unsettling, they're evidence that the ICD is effectively treating your heart rhythm problem and protecting you from sudden death. Talk to your doctor about how to best care for your ICD.
After your procedure, you'll need to take some precautions to avoid injuries and make sure your ICD works properly.
You'll likely be able to return to normal activities, such as exercise, work and sex, soon after you recover from surgery. Follow your doctor's instructions. During the first four weeks following surgery, your doctor may ask you to refrain from:
- Vigorous above-the-shoulder activities or exercises, including golf, tennis, swimming, bicycling, bowling or vacuuming
- Lifting anything weighing more than 5 pounds
- Playing contact sports
- Strenuous exercise programs
Problems with your ICD due to electrical interference are rare. Still, take precautions with the following:
- Cellular phones and other mobile devices. It's safe to talk on a cellphone, but avoid placing your cellphone within 6 inches (about 15 centimeters) of your ICD implantation site when the phone is turned on. Although unlikely, your ICD could mistake a cellphone's signal for a heartbeat and slow your heartbeat, causing symptoms, such as sudden fatigue.
- Security systems. After surgery you'll receive a card that says you have an ICD. Show your card to airport personnel because the ICD may set off airport security alarms. Also, hand-held metal detectors often contain a magnet that may interfere with your ICD. Limit scanning with a hand-held detector to less than 30 seconds over the site of your ICD or make a request for a manual search.
- Medical equipment. Make sure your doctors know you have an ICD. Some procedures, such as magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and radiofrequency or microwave ablation are not recommended if you have an ICD.
- Power generators. Stand at least 2 feet (0.6 meters) from welding equipment, high-voltage transformers or motor-generator systems. If you work around such equipment, your doctor can arrange a test in your workplace to see if the equipment affects your ICD.
- MP3 player headphones. Although the player itself poses little risk, the headphones may be a problem. Most contain a magnetic substance and can interfere with your ICD. Keep your headphones at least 6 inches (about 15 centimeters) from your ICD.
Devices that pose little or no risk to your ICD include microwave ovens, televisions and remote controls, AM/FM radios, toasters, electric blankets, electric shavers and electric drills, computers, scanners, printers, and GPS devices.
If you have an implantable cardioverter-defibrillator to treat ventricular arrhythmia, driving a vehicle presents a special challenge. The combination of arrhythmia and shocks from your ICD may cause fainting, which would be dangerous if you're driving.
The American Heart Association's guidelines say everyone who receives an ICD for primary prevention should avoid driving for one week after ICD placement, but make sure you talk to your doctor for specific recommendations. The guidelines discourage driving during the first six months after your procedure if your ICD was implanted due to a previous cardiac arrest or ventricular arrhythmia. If you experience no shocks during this period, you will likely be able to begin driving again. But if you later experience a shock, with or without fainting, tell your doctor and follow his or her recommendations.
In most cases, you will need to stop driving until you've been shock-free for another six months. There is some controversy regarding this topic. For example, the European Heart Rhythm Association recommends waiting only three months before driving if your ICD was implanted due to a previous cardiac arrest or arrhythmia, while the American Heart Association recommends waiting six months. Talk to your doctor to get advice for your situation.
If you have an implantable cardioverter-defibrillator but have no history of life-threatening arrhythmias, you can usually resume driving within a week after your procedure, with your doctor's approval, if you've had no shocks. Discuss your specific situation with your doctor. You usually can't get a commercial driver's license if you have an ICD.
The lithium battery in your implantable cardioverter-defibrillator can last up to seven years. During your regular checkups, which should occur every three to six months, your doctor or nurse will check the battery. When the battery is nearly out of power, your old shock generator is replaced with a new one during a minor outpatient procedure.
ICDs and end-of-life issues
If you have an ICD and become terminally ill with a condition unrelated to your heart, such as cancer, it's possible that your ICD could prolong the process of dying.
If you have an ICD implanted and later become terminally ill, talk to your doctor about your wishes. You may also want to talk to family members or another person designated to make medical decisions for you about what you'd like to do in end-of-life care situations. It's easy to turn off your ICD, and turning it off may prevent unnecessary suffering.
June 04, 2013
- Implantable cardioverter defibrillator. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/icd/icd_all.html. Accessed March 14, 2013.
- Epstein AE, et al. 2012 ACC/AHA/HRS focused update incorporated into the ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities. Circulation. 2013;127:e283.
- Devices that may interfere with implantable cardioverter defibrillators (ICDs). American Heart Association. http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Devices-that-may-Interfere-with-Implantable-Cardioverter-Defibrillators-ICDs_UCM_448464_Article.jsp. Accessed March 14, 2013.
- Living with your implantable cardioverter defibrillator (ICD). http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Living-With-Your-Implantable-Cardioverter-Defibrillator-ICD_UCM_448462_Article.jsp. Accessed March 14, 2013.
- Banning AS, et al. Driving and arrhythmia: A review of scientific basis for international guidelines. European Heart Journal. 2013;34:236.
- Epstein AE, et al. Addendum to ''Personal and public safety issues related to arrhythmias that may affect consciousness: Implications for regulation and physician recommendations — A medical/scientific statement from the American Heart Association and the North American Society of Pacing and Electrophysiology" public safety issues in patients with implantable defibrillators. Circulation. 2007;115:1170.
- Eifling M, et al. The evaluation and management of electrical storm. Texas Heart Institute Journal. 2011;38:111.