Bioimpedance analysis (BIA) is a commonly used method to estimate body composition by sending a low-level electrical current through the body. Manufacturers have traditionally recommended that patients with implanted cardiac devices like pacemakers, implantable cardioverter defibrillators (ICDs), or cardiac resynchronisation therapy devices (CRT-Ds) avoid BIA due to concerns about potential interference.
However, a small study published in 2012 evaluated 20 patients with heart failure who had either an ICD or CRT-D device implanted. The researchers performed BIA on these patients while monitoring their devices in real time. They found no evidence of any interference from the BIA, including no telemetry disruption, no oversensing on the device leads, and no symptoms experienced by the patients.
While this study suggests BIA may be safe in patients with certain cardiac implants, the researchers noted that further confirmatory studies with larger patient groups are still needed. As always, it’s best to consult your doctor or cardiac electrophysiologist before undergoing any procedures or tests if you have an implanted cardiac device.
There is theoretically a risk of damage to the ICD/lead from an electric shock from UK mains buts it’s extremely unlikely and it would be classed as a very low risk.
This is because the current tends not to pass through the ICD/lead but passes through the body to the ground using the shortest and quickest route e.g. hand, up the arm, down the torso, and out through the leg. The majority of devices also have circuitry built in to protect them against electrical surges.
The advice would be to go to the hospital if a person was feeling unwell, otherwise, it would be recommended that a person contact their local device clinic and request a device check which could be performed as a remote transmission. This would pick up on any rare issues caused and provide reassurance.
It is unlikely. Studies show that AEDs interpret the victim’s heart rhythm more quickly and accurately than many trained emergency professionals. If the AED determines that no shock is needed, it will not allow a shock to be given.
AEDs are safe to use by anyone who has been shown how to use them.
The AED’s voice guides the rescuer through the steps involved in saving someone; for example, “apply pads to patient’s bare chest” (the pads themselves have pictures of where they should be placed) and “press red shock button.” Furthermore, safeguards have been designed into the unit precisely so that non-medical responders can’t use the AED to shock someone who doesn’t need a shock.
Treating SCA is a high-stress situation. Even experienced health care providers do not do everything perfectly. During SCA, performing CPR and using an AED can only help the victim.
Unfortunately, because of other underlying medical or heart problems, a victim of SCA who is in VF may not survive even if defibrillation is done promptly and correctly.
AEDs are extremely safe when used properly. The electric shock is designed to go from one electrode pad to another through the victim’s chest. Basic precautions, such as verbally warning others to stand clear and visually checking the area before and during the shock, can maximize the safety of rescuers.
CPR provides some circulation of oxygen-rich blood to the victim’s heart and brain. This circulation delays both brain death and the death of heart muscle. CPR also makes the heart more likely to respond to defibrillation.
Start CPR immediately. Once the AED is present, apply the electrode pads to the victim’s bare chest, and follow the AED’s voice prompts and messages. It will tell you when to resume CPR.
There is no specific legal requirement for employers to provide defibrillators in the workplace. The Health and Safety Executive’s syllabus of first aid training for offshore installations does include the use of defibrillators, but this is not extended to onshore first aid. However, the Health and Safety (First-Aid) Regulations 1981 do not prevent an employer from providing defibrillators that could benefit both their employees and the public.
If you think an AED should be installed in your workplace, read the Guide to AEDs written by Resuscitation Council UK and the BHF as this will answer your questions in detail. If you wish to proceed, contact your local ambulance service for further advice as described in the Guide.
Fortunately, sudden cardiac arrest (SCA) in school-age children is rare. Resuscitation attempts at schools are more likely to be made on an adult (staff member or visitor) than a pupil. The presence of an AED at a school therefore provides potential benefit for everyone present at the site.
An additional and important advantage of having an AED prominently located at a school is that students become familiar with them and can learn about first aid, resuscitation and the purpose of defibrillation.
Yes. Fortunately, cardiac arrest is rare in people who are pregnant, but if it were to occur it is quite appropriate to use an AED. The procedure is the same as in the non-pregnant but it is important to place the pads clear of enlarged breasts.
Yes. The incidence of shockable rhythms requiring defibrillation in children is very low but can occur. The priority must always be for high-quality CPR and getting expert help. However, the AED can be used across all age groups if this is the only available machine.
Experience with the use of AEDs (preferably with dose attenuator) in children younger than one year is limited. The use of an AED is acceptable if no other option is available as, on balance, it is probably better to give a 50 J shock than nothing at all. The upper safe limit for dosage in this group is unknown.
AEDs have been used by untrained people to save lives. Clear, spoken instructions and visual illustrations guide users through the process. Lack of training should not be a barrier to someone using one. If a person is in cardiac arrest, do not be afraid to use an AED.
Public Access Defibrillation describes the use of AEDs by members of the public. AEDs can now be found in many busy public places including airports, mainline railway stations, shopping centres, and gyms. They are meant to be used by members of the public if they witness a cardiac arrest.
AEDs are very reliable and will not allow a shock to be given unless it is needed. They are extremely unlikely to do any harm to a person who has collapsed in suspected Sudden Cardiac Arrest. They are safe to use and present minimal risk to the rescuer. These features make them suitable for use by members of the public with little or no training).
Resuscitation Council UK and British Heart Foundation have written a Guide to Automated External Defibrillators (AEDs) which gives full information about the use of AEDs in the community. We urge you to read this as it will answer your questions in more detail.
Fortunately, out-of-hospital cardiac arrest (OHCA) in childhood is a rare event. Studies of OHCA in children and adolescents (excluding infants under one year old) report an incidence between 3 and 9 per 100,000 per year. The rates reported in infants are generally much higher (between 11 and 72 per 100,000 infants per year). The cause in this latter group is often attributed to the Sudden Infant Death Syndrome (SIDS).
The incidence of cardiac arrest from a primarily cardiac cause (which includes cases referred to as “sudden cardiac arrest” or SCA) has been reported to be 2 – 3 per 100,000 per year in children and adolescents. SCA is more common in boys than girls, and more likely to occur during or just after sporting activity.
Warning symptoms for future SCA may include previous episodes of collapse or near-collapse, dizziness, palpitations, chest pain, shortness of breath or unexplained episodes of brief seizure-like activity. Such symptoms may not always be present, however, and can be difficult to interpret in the setting of sporting activity, where those participating may often be pushing themselves to the point of exhaustion. A family history of cardiovascular disease and unexplained death at a young age may also be highly relevant.
Survival rates of 1.9 – 11.1% following attempted resuscitation have been reported, with good neurological outcomes in many. Survival is more likely with witnessed events and a shockable rhythm on first ECG analysis – conditions often seen when an arrest occurs in a public location, like a school.
The core principles of CPR – ventilation to provide breathing and chest compressions to support the circulation – apply equally to children and adults.
Many children do not receive CPR because potential rescuers are not sure if there are specific methods recommended for children, and are afraid of causing harm. This fear is unfounded; it is far better to use the adult CPR sequence for the resuscitation of a child than to do nothing. When performing chest compressions, compress the child’s chest by 1/3 to 1/2 of its depth – don’t be afraid to push hard.
Although slightly different techniques are taught to those people (particularly healthcare workers) who have special responsibilities for the care of children, the differences are not crucial, and it is far more important to do something using the techniques you have been taught.
Training in CPR is provided by many organisations, and some classes also include instruction in the use of an AED. Many different kinds of training are provided, ranging from ‘hands-on’ classes with training manikins to purely internet-based distance-learning instruction. It is recommended that training should include practice on a training manikin.
Many ambulance services also teach the general public: contact your local service for further details.
The voluntary first aid organisations (for example St John Ambulance, St. Andrew’s Ambulance, The British Red Cross and the Royal Life Saving Society) provide instruction; contact the branch nearest to you for details. There are also many private first aid training companies that provide training, and an internet search will identify those in your area
It is very unlikely that someone in the UK who acted in good faith when trying to help another person would be held legally liable for an adverse outcome. No such action has ever been brought against someone who performed CPR and, in general, the courts in the UK look favourably on those who go to the assistance of others.
In the UK fewer than 10% of all the people in whom a resuscitation attempt is made outside the hospital survive. Improving this figure is a major priority for Resuscitation Council UK, the Department of Health and Social Care, ambulance services and first aid organisations.
When all the stages in the Chain of Survival take place promptly, the figures are very much better. This is possible where the arrest is recognised immediately, bystanders perform CPR, and an automated defibrillator is used before the ambulance service arrive. Survival rates in excess of 50% have been reported under these circumstances.
When the heart is restarted after a cardiac arrest, recovery is not immediate. Admission to the hospital is always required for further treatment and investigation to establish the cause. Provided good CPR has been performed while the heart has stopped and defibrillation has been carried out promptly, the outlook is promising with most patients making a good recovery.
Compression-only CPR describes the performance of uninterrupted chest compressions without rescue breathing. In many adults who suffer a cardiac arrest, the heart stops abruptly; breathing will have been normal (or nearly normal), so the blood should be well oxygenated. In this situation, compression-only CPR may be effective for the first few minutes after the heart stops. This may provide time for the emergency services to arrive or an AED to be collected. Ultimately the oxygen will be used up and rescue breaths are required to give the victim the best chance of resuscitation.
Where a cardiac arrest is caused by lack of oxygen (as in drowning and most arrests that occur in children) compression-only CPR will be much less effective.
Chest compression alternating with rescue breaths is the ideal first aid procedure, but for untrained bystanders or those unwilling to give rescue breaths, compression-only CPR (hands only) is a useful alternative.
If bystanders who witness a cardiac arrest perform CPR, sufficient blood containing oxygen will reach the brain, heart and other organs to keep the person alive for several minutes. CPR by itself will not restart the heart, but it ‘buys time’ for the emergency medical services to reach the scene. Effective CPR more than doubles the chance of someone surviving a cardiac arrest.
Yes, it is safe to defibrillate a victim who is lying on a metallic or wet surface. If the self-adhesive pads are applied correctly and provided there is no direct contact between the user and the victim when the shock is delivered, there is no direct pathway that electricity could take that would cause the user to experience shock.
If the victim is wet, their chest should be dried so that the self-adhesive AED pads will stick properly. As with any attempt at defibrillation, particular care should be taken to ensure that no one is touching the victim when a shock is delivered.
Some survivors of cardiac arrest experience medical problems, including impaired consciousness and cognitive deficits. Functional recovery continues over the first six to 12 months after out-of-hospital cardiac arrest in adults. It is common for survivors to have memory loss and to experience depression and anxiety for some time after their event.
Most people who survive SCA can return to their previous level of functioning. All survivors need follow-up care with physicians who specialize in heart conditions (cardiologists and electrophysiologists).
Therapeutic hypothermia (TH) is considered an important therapy for a comatose survivor of cardiac arresta patient whose heart stopped beating, was restarted during cardiopulmonary resuscitation (CPR), and who remains minimally responsive immediately after the event. It is endorsed by the American Heart Association and is performed by lowering the body temperature to 32-34ºC (approximately 90 to 93ºF). Normal body temperature is 98.6º F or 37ºC. TH works by protecting the brain and other vital organs. It lowers oxygen requirements, decreases swelling, and limits the release of toxins, which can cause cells to die. TH has been shown to improve neurological outcomes and increase survival in patients who remain in a coma after successful CPR.
About one in 10 EMS-treated SCA victims survives. However, there are large regional variations in survival to hospital discharge, which are largely due to bystander intervention with CPR and AEDs. When bystanders give CPR, survival rates can triple. When bystanders give CPR and use AEDs, survival rates can be as high as 50%.
No. A person who has suffered Sudden Cardiac Arrest is clinically dead. It is not possible to cause further injury by performing CPR or using an AED. The federal Cardiac Arrest Survival Act and state Good Samaritan laws are designed to protect laypersons from legal liability risk. Although laws vary from state to state, they generally encourage bystanders and the lay public to perform CPR and to use an AED. Depending on state law, the categories of people who are given protection include the lay public and sometimes first responders and medical professionals. Depending on state law, protection is granted unless the responder is negligent (fails to provide reasonable care), or grossly negligent (acts with a conscious disregard for the safety of the victim).
People who are at risk for SCA may want to consider having an AED at home. Regardless of known risk, since seven out of 10 SCAs occur at home, placing these devices in homes could save many lives.
Logical locations for AED placement include police cars, airports, train, bus and subway stations, highway rest stops, sports arenas, doctor and dentist offices, health clinics, fitness clubs, shopping malls, large grocery stores, theatres, workplaces, schools, churches and retirement communities. Research has shown some of the best locations for AED placement are in 24-hour coffee shops or near ATMs. Increasingly, consumers are choosing to purchase AEDs for their homes and vehicles, since most SCAs outside hospital settings occur in home settings.
Defibrillators sometimes used on ambulances and in hospitals, and often seen on TV, are manual defibrillators. They are larger than AEDs and are designed to be used by medical personnel with special training. In contrast, AEDs are smaller, computerized devices designed so that virtually any operator can use them by simply following the audio and visual prompts.
AEDs are designed to treat victims in SCA with an irregular heart rhythm called ventricular fibrillation (VF). AEDs work best in these victims if they are used quickly and if the victim has received cardiopulmonary resuscitation (CPR).
If the victim has an implantable pacemaker or defibrillator with a battery pack (visible as a lump under the skin), avoid placing the pad directly on top of the implanted medical device.
Never place AED electrode pads directly on top of medication patches. If the patch is in the way of the AED pads, remove it and wipe off the area with the victim’s shirt. Do not touch the patch with bare skin. Then apply the pads to the clean, bare skin.
No, not if you use it properly. The electric shock is programmed to go from one pad to the other through the victim’s chest. Basic precautions, such as not touching the victim during the shock, ensure the safety of rescuers and bystanders.
No. Most SCA victims will die if they are not treated immediately. Your actions can only help. AEDs are designed in such a way that they will only shock victims who need to be shocked.
An AED is designed for use by any bystander, regardless of training. The AED uses voice and visual prompts to advise the user how to apply electrode pads and whether or not to administer a shock. Some devices shock automatically if the victim has a fatal heart rhythm. Training is recommended since many victims also need CPR (cardiopulmonary resuscitation).
A computer inside the AED analyzes the victims heart rhythm. The device determines whether a shock is needed. Some devices shock the victim automatically if a shock is needed. Other devices require that the operator press a button to deliver the shock. The shock is delivered through pads applied to the victims bare chest. The shock stuns the heart, stopping abnormal heart activity and allowing a normal heart rhythm to resume.
Yes. The chances of survival from SCA increase dramatically if the victim receives immediate CPR and treatment with an automated external defibrillator (AED). AEDs are designed for use by laypersons and provide visual and voice prompts. They will not shock the heart unless shocks are needed to restore a healthy heartbeat. Bystander intervention with CPR and AEDs can greatly improve the likelihood of survival. In fact, if bystanders use AEDs before EMS arrival, survival rates can be as high as 50%.
An AED, or automated external defibrillator, is a device that automatically analyzes heart rhythms and advises the operator to deliver a shock if the heart is in a fatal heart rhythm. It is designed for use by untrained bystanders. AEDs are safe and cannot hurt the victim.
CPR, or cardiopulmonary resuscitation, involves pushing on the center of the chest (between the nipples) hard and fast (100-120 pumps per minute) to circulate oxygenated blood already in the body to the brain and other organs.
SCA is treatable most of the timeespecially when it is due to an electrical abnormality called ventricular fibrillation as long as it is treated quickly. Treatment includes cardiopulmonary resuscitation (CPR) and the use of defibrillators. This treatment must be provided immediately to be effective, ideally within three to five minutes after collapse. Even the fastest emergency medical services may not be able to reach a victim this quickly. That is why prompt action by bystanders is critical and why it is so important that more laypersons learn CPR and how to use an automated external defibrillator (AED).
Laypersons should be prepared to recognize the emergency, call for professional help, give CPR and use the nearest AED. If the person is not responsive and not breathing normally, one should suspect SCA and start CPR. This has been called the “No-No-Go” protocol. When a person suffers cardiac arrest, he or she is clinically dead, but life can often be restored with immediate bystander action.
Subsequent care includes administration of medications and other advanced cardiac life support techniques by emergency medical personnel. Patients who have been successfully resuscitated but remain in a coma after cardiac arrest due to ventricular fibrillation (VF) may benefit from mild therapeutic hypothermia (cooling), which can improve the chances of survival with good brain function. SCA survivors should see heart specialists (cardiologists and electrophysiologists) for follow-up care.
A wearable cardioverter defibrillator (WCD) is prescribed for patients at risk of SCA. It consists of a garment, an electrode belt, and a monitor. While some defibrillator devices are implanted under the skin, the wearable defibrillator is worn under the clothes, directly against the patients skin.
An implantable cardioverter-defibrillator (ICD) is a battery-powered device placed under the skin to monitor the heart rate. If an abnormal heart rhythm is detected (i.e., the heart is beating chaotically or too fast), the device will deliver a shock to restore a normal heartbeat. ICDs can prevent cardiac arrest in high-risk patients.
Living a healthy lifestyleexercising regularly, eating healthy foods, maintaining a healthy weight, and avoiding smokingcan help prevent SCA. Monitoring and controlling blood pressure, cholesterol levels and diabetes is also important. If there is a family history of SCA, it is important to be checked by a cardiologist or electrocardiologist. If abnormal heart rhythms (arrhythmias) are detected, they can be treated through implantable cardioverter defibrillator (ICD) therapy, use of medications such as ACE inhibitors, beta blockers and calcium channel blockers, and catheter ablation. Some patients, especially those who have had previous heart attacks, may benefit from the use of wearable cardioverter defibrillators (WCDs).
While there are a number of possible causes, there are three common causes. One cause is Hypertrophic Cardiomyopathy (HCM), a congenital heart muscle disease in which the walls of the hearts left ventricle become abnormally thickened. The structural abnormality can lead to obstruction of blood flow from the heart, causing loss of consciousness and an irregular heartbeat, leading to SCA. Another cause, Long QT syndrome, is an often-unrecognized congenital condition that predisposes the child to an abnormality in the hearts electrical system that can lead to SCA. Episodes are most commonly triggered by physical exertion or emotional stress. Finally, commotio cordis is an electrical disturbance caused by a blow to the chest. It occurs most often in baseball, but has been reported in other sports and situations in which there is a blow to the chest.
Ejection fraction (EF) refers to how well the heart is pumping. It’s the percentage of blood that is pumped out of the hearts main pumping chamber during each heartbeat. If the EF is low (35% or lower), the person is at increased risk for sudden cardiac death. It is important to know that the EF can change over time.
Low ejection fraction or weak heart muscle
Prior heart attack
Heart failure
Abnormal heart rate or heart rhythm (arrhythmia)
Family history of arrhythmia
Family history of sudden cardiac death
Congenital heart defects
Hypertrophic cardiomyopathy (a thickened heart muscle that especially affects the ventricles)
Viral infection in the heart
History of syncope (fainting)
Coronary artery disease (CAD) and risk factors for CAD, including smoking, high blood pressure, diabetes, high cholesterol, obesity, and a sedentary lifestyle
Significant changes in blood levels of potassium and magnesium (e.g., from using diuretics)
Recreational drug use.
When SCA happens outside a hospital setting, it occurs most often in a home or residence, followed by public settings and nursing homes. About 7 in 10 events occur in home settings.
No. SCA is an electrical problem in the heart. When people have SCA, they are not awake, their hearts are not beating, and they are unable to communicate. Symptoms of SCA include sudden loss of responsiveness and absence of normal breathing. In contrast, a heart attack is a circulatory problem in the heart. When people have heart attacks, they are awake, their hearts are beating, and they are able to communicate. Symptoms of heart attack can include chest discomfort; pain or discomfort in one or both arms, the back, neck, jaw or stomach; shortness of breath; sweating; nausea; and lightheadedness. Heart attacks can lead to SCA, but there also are many other causes.
No. While the average SCA victim is about 60-years-old, SCA affects people of all ageseven children and teens. Thousands of youth under the age of 18 experience SCA each year in the U.S.
SCA is the third leading cause of death in the U.S. It affects about 1,000 people outside hospital settings every day. Unfortunately, only one in 10 victims survive.
Usually, the first sign of SCA is loss of consciousness (fainting). Typically, the person collapses and doesnt respond or breathe normally. They may gasp or shake as if having a seizure.
SCA can result from cardiac causes (abnormalities of the heart muscle or the hearts electrical system), external causes (drowning, trauma, asphyxia, electrocution, drug overdose, blows to the chest), and other medical causes such as inflammation of the heart muscle due to infection. Most SCAs are caused by an abnormal heart rhythm (arrhythmia). The most common life-threatening arrhythmia is ventricular fibrillation, which is an erratic, disorganized firing of impulses from the ventricles (the hearts lower chambers). When this occurs, the heart is unable to pump blood and death will occur within minutes if left untreated. Heart attacks can also lead to SCA.
Sudden Cardiac Arrest (SCA) is a life-threatening emergency that occurs when the heart suddenly stops beating. It strikes people of all ages who may seem to be healthy, even children and teens. When SCA happens, the person collapses and doesn’t respond or breathe normally. They may gasp or shake as if having a seizure. SCA leads to death in minutes if the person does not get help right away. Survival depends on calling for professional help, starting CPR, and using an AED as soon as possible.
Maintain at least the recommended distance between the item and your heart device:
12-Inch Distance
Car/Motorcycle from components of ignition system
Electric Fence
Electric Pet Containment Fence from buried wire and indoor antenna
Transformer Box (green box in yard)
2-Foot Distance
Beach Comber Metal Detector from search head
Induction Cooktop Stove
Not Recommended
Ab Stimulator
Electronic Body Fat Scale
Magnetic Mattress Pad/Pillow
Maintain at least a 6-inch distance between the item and your heart device:
Electric Grocery Cart/Golf Cart from motor
Electric Kitchen Appliances hand-held (electric mixer or knife)
Electric Shaver corded
Electric Toothbrush Charging Base
Exercise Bike from magnet in wheel
Hair Dryer hand-held
Hand-held Back Massager
Magnetic Therapy Products
Radio-Controlled Items from antenna
Sewing Machine/Serger from motor
Small Magnet (household magnet)
Speakers
Tattoo Machine
Treadmill from motor
Ultrasonic Pest Controller
Vacuum Cleaner from motor
If the item is used as intended and in good working condition, there is no known risk:
Battery Charger for household batteries
Casino Slot Machine
CD/DVD/VHS Player or Recorder
Curling Iron
Dishwasher
Electric Blanket
Electric Guitar
Electric Toothbrush
Electronic Weight Scale
Garage Door Opener
Hair Straightener
Heating Pad
Hot Tub
Ionized Air Filter
Iron
Kitchen Appliances small and large (blender, can opener, refrigerator, stove, toaster)
Low Voltage Residential Power Lines
Massage Chair/Pad
Medical Alert Necklace
Microwave Oven
Remote Control (CD, DVD Player, TV, VHS)
Salon Hair Dryer
Sauna
Shaver/Trimmer battery powered
Tanning Bed
TV
Yes, but extreme caution should be excised at all times.
Follow the safety precautions below to minimize the risk of interfering with your heart device while using a chainsaw.
Maintain a 6-inch distance between the motor of an electric chainsaw and your heart device.
Ensure the equipment is properly grounded.
Maintain a 12-inch distance between the components of the ignition system of a liquid fuel-powered chainsaw and your heart device. Also, it is better to use one that is built with the spark plug located away from the handgrips.
Immediately stop cutting and turn off your chainsaw if you start feeling lightheaded, dizzy, or you believe your implantable defibrillator has delivered a shock
Do not work on the engine while it is running
Do not touch the coil, distributor, or spark plug cables of a running engine
The electromagnetic energy generated by a chainsaw is similar to other electric and liquid fuel-powered tools. If electromagnetic interference occurs with your heart device and you experience symptoms such as becoming dizzy or lightheaded, a running chainsaw may present a higher risk of injury to you than other power tools.
It is recommended you avoid using welding currents above 160 amps. Follow the safety precautions below to minimize the risk of interfering with your heart device while welding with currents under 160 amps.
Welding Safety Precautions
Limit welding to currents less than 160 amps Work in a dry area with dry gloves and shoes Maintain a 2-foot (60cm) distance between the welding arc and heart device Keep the welding cables close together and as far away as possible from your heart device. Place the welding unit approximately 5 feet from the work area. Connect the ground clamp to the metal as close to the point of welding as possible. Arrange the work so the handle and rod will not contact the metal being welded if they are accidentally dropped. Wait several seconds between attempts when having difficulty starting a weld Work in an area that offers firm footing and plenty of room for movement Work with an informed person who understands these suggestions Immediately stop welding and step away from the area if you start feeling lightheaded, dizzy, or you believe your implantable defibrillator has delivered a shock
Since welding equipment may temporarily affect the normal operation of your heart device, any decision you make to use this equipment should be made in consultation with your heart doctor. Your doctor can advise you as to the degree of risk these responses pose for your medical condition.
Aprons or vests will not effectively shield your pacemaker or implantable defibrillator from the electromagnetic energy generated by welding equipment.
Unlike most other household power tools, welding with currents above 160 amps may have a higher tendency to temporarily affect the normal function of your pacemaker or implantable defibrillator.
Even though most electromagnetic fields in the home environment will rarely affect the function of a pacemaker or implantable defibrillator, it is recommended you keep any item containing magnets away (at least 6 inches/15 centimeters) from your pacemaker or implantable defibrillator.
The reason for this is because there is a small magnetically activated switch built into the electronics of pacemakers and implantable defibrillators. This internal switch is designed to close when a magnet of enough strength is placed over it.
When the internal switch is closed in the pacemaker, the pacemaker paces the heart at a continuous pre-set rate (which could be different than the rate your doctor programmed).
When the internal switch is closed in an implantable defibrillator, it prevents it from delivering treatment therapies.
You may not always know if an item has a magnet in it. However, if you use household items as they are intended, and they are properly maintained, they should have no effect on your heart device. This includes microwaves, kitchen appliances, cordless phones, radios, televisions, video games, CD players, hair dryers, electric shavers, electric toothbrushes, electric blankets, leaf blowers, lawn mowers, garage door openers, computers, and small shop tools.
If you mistakenly place a magnet too close to your heart device, simply move the item away.
Removing the magnet returns the pacemaker or implantable defibrillator back to its previous, normal programming.
The use of magnetic mattress pads and pillows is not recommended since it would be difficult to keep a 6-inch (15 centimeter) separation from your heart device.
Given the short duration of security screening, it is unlikely that your heart device will be affected by metal detectors (walk-through archways and hand-held wands) or full-body imaging scanners (also called millimetre wave scanners and 3D imaging scanners) such as those found in airports, large venues and courthouses.
The metal case of your heart device could set off a metal detector. To minimize the risk of temporary interference with your heart device while going through the security screening process, avoid touching metal surfaces around any screening equipment. Do not stop or linger in a walk-through archway; simply walk through the archway at a normal pace.
If a hand-held wand is used, ask the security operator not to hold it over your heart device and not to wave it back and forth over your heart device. You may also request a hand search as an alternative. If you have concerns about these security screening methods, show your device ID card, request an alternative screening, and then follow the instructions of the security personnel.
Yes. Anti-theft detectors in stores and libraries generate electromagnetic fields that can sense embedded tags on merchandise. It may be possible, under unique circumstances, for these fields to temporarily affect the operation of your heart device. Significant effects from interference are unlikely if you pass normally through the detectors. It is recommended that you:
Be aware of anti-theft detectors
Walk through at a normal walking speed
Dont linger close to the detection system equipment. If you are near an anti-theft system and feel symptoms, promptly move away from the equipment. Your heart device will resume its previous state of operation when you move away from the equipment.
Your doctor should discuss all potential benefits and risks of an MRI scan with you. Present your ID card to the doctor recommending the MRI scan. If needed, your doctor can seek more information from the manufacturer of your ICD.
Intimacy is a normal part of life. We understand patients resume sexual activity when they feel comfortable. However, if you have a question, it may be helpful to have a conversation with your doctor. If in doubt about an activity, always discuss it with your doctor or nurse.
It is rare. Your ICD is programmed to allow your heart to normally rise without treatment shocks being delivered. Your device should only deliver a shock when your heart rate meets the specific criteria programmed by your heart doctor. If you receive a shock during intimacy or other activities, contact your physician. Your doctor will then determine the cause of the shock and may also make adjustments in the programming of your heart device.
Most patients are able to return to work after device implant. You and your doctor will make this decision. The timing will depend on many things, including the type of work you do.
Cardiac resynchronization therapy (CRT) helps restore a normal heart rhythm by pacing both sides of the heart. CRT delivers a steady pattern of small electrical pulses to the heart muscle through the leads. These small pulses encourage the heart to beat in a regular rhythm.
Many people with an ICD or CRT-D resume their normal daily activities after full recovery from surgery. However, there may be certain situations that your doctor will ask you to avoid. Your doctor or nurse will provide guidance for your particular condition.
An ICD or CRT-D is implanted to help you live a normal life. An ICD is there to provide you with 24-hour security against occurrences of sudden cardiac arrest (SCA). A CRT-D ensures patients feel better as their heart is pumping enough blood and oxygen to the body, as well as 24-hour security against occurences of SCA.
Patients who are indicated for a ICD are at higher risk for sudden cardiac arrest (SCA). The ICD is implanted to help protect the patient from sudden cardiac arrest.
There are three types of heart block. A heart block is a type of heart problem where the electrical impulses traveling from the upper chambers (left and right atria) to the lower chambers (ventricles) are either:
Yes. A hearing aid can be worn in the ear if you have an ICD. If the hearing aid has any wireless accessories, such as a Bluetooth streamer worn around the neck, keep the accessory at least 6 inches away from the device.
ICDs connect to different chambers of the heart with 1 to 3 leads. The device and each lead are programmed individually based on your needs. Talk to your doctor if a lead needs to be turned off and how that may impact ICD therapy.
Yes, it could. Your mobile phone, as well as any accessories containing magnets (such as earbuds or cases with magnetic clasps) need to be kept at least 6 inches away from your device.
Yes, you can ride a bike with an ICD. However, if using a stationary exercise bike, keep the wheel magnet at least 6 inches away from your heart device. Also, be sure to check with your doctor in case there are any medical concerns.
Your heart device can be programmed to make a beeping tone when something has happened that your doctor needs to be aware of. If you hear a beeping tone, contact your doctor. Your doctor can discuss with you what has happened. Your doctor can also program your heart device to send heart information automatically through a wireless device to your clinic. Your doctor will explain the type of wireless device that will be used to send your heart information.
They may feel something if you are touching them when you receive a shock, just as they might if you were touching out of the water. They will not be affected differently because you are in a pool.
There are four main companies that make defibrillators, including Medtronic, Boston Scientific, St. Jude Medical (Abbott) and Biotronik. Several smaller companies also manufacture ICDs.
Lead perforation is a potential complication occurring rarely in heart device implant procedures. It occurs when a lead pokes through the heart wall instead of embedding into the heart wall muscle.
DDD and VVI are pacemaker therapy modes that your doctor can program in your device. These are just two of many options. Each letter indicates something different (A=Atrium; V=Ventricle; D=Dual or both A and V; and O=none). The first letter indicates the chamber of the heart being paced. The second letter is the heart chamber being sensed. The third letter indicates how the device should respond when it senses a cardiac event (T=Triggered; I=Inhibited; D=Trigger or Inhibit; and O=none). Finally, the fourth letter, usually R, means that the rate response in the device is turned on (R=Rate Modulation on; O or blank = none or no rate modulation).
Depending on your body structure and the size of your ICD, you may see the device under your skin. The bump will be about the same size as the ICD and may be visible if you wear strapless clothing. The scar is typically about 2 inches long, just below the collarbone.
Bras with underwires will not affect your ICD. However, the strap from any bra may cause discomfort at the implant site until the incision heals from the surgery.
ICDs are programmed to meet a person’s needs. Typically, an ICD will be set to deliver 20-35 joules per shock. Talk to your doctor to discuss how your ICD is programmed.
When your heart device is implanted, your doctor threads one end of the lead through a vein into your heart, attaching the lead tip to the heart wall. Your doctor then connects the other end of the lead to your heart device.
The amount of battery used to deliver a shock depends on the specific ICD manufacturer and model, as well as the amount of energy your device is programmed to deliver. When longevity is estimated for ICDs, the frequency of device charging is included.
Your ICD has an outer case, a battery, a small computer, and a connector block at the top of the case that connects the device to the leads. All electronic parts are sealed inside a metal case, sometimes called a can, made of titanium.
A pacemaker contains a very small computer that controls the pacemaker operation. It is powered by a tiny lithium battery. All electronic components of your pacemaker are sealed inside a metal case made of titanium.
Medtronic provides an ID card when you receive your ICD implant. Try a web search (perhaps one that rhymes with oogle), or check with your local pharmacy if you prefer to wear medical jewelry along with carrying your ID card in your wallet.
It is common to have some soreness and tenderness at the incision site for several days after the procedure. There also may be some bruising. Healing of the incision is usually complete within 7 to 14 days. Your doctor may place restrictions on lifting and activities for several weeks following your surgery to allow for complete healing.
A body fat scale estimates percentage of body fat by passing electrical current through the body. Because this current may interfere with your ICD, it is recommended you contact your device manufacturer for a list of acceptable BMI scales.
Remote monitoring is an option that many people find convenient because it can decrease the number of clinic visits for follow-up. These days, some heart devices can even be monitored via an app on a patient’s smartphone. Discuss this option with your doctor to see if it’s right for you.
ICDs connect to the different chambers of your heart using 1 to 3 leads. Your doctor will determine the number of leads implanted based on your individual needs.
Most people are aware of getting an ICD shock and each describes the event differently. Those who are awake during a therapy shock describe it as a kick in the chest. The shock startles them, but the feeling passes quickly. Some find it fleeting but still distressing. Others find the therapy shock a reassuring reminder that their heart device is protecting them from sudden cardiac arrest. Some people lose consciousness because of a rapid heartbeat, and they are not aware they received a therapy shock.
Each patient describes an ICD shock differently. Some say it feels like a thump on the chest while others compare it to being kicked in the chest. It is normal to feel apprehensive, but also remember that a defibrillating shock from an ICD can be lifesaving. For most people, if there is pain, it quickly passes.
Your doctor will discuss any restrictions to activities that may be necessary after you have healed from your surgery. It is unlikely that your ICD will affect your playing the cello.
Each ICD manufacturer may have proprietary components and unique patented therapies, resulting in many variations among their devices. There may be differences in features such as battery longevity, size and shape, available therapies, and remote monitoring services. Your doctor will decide/recommend whats right for you.
Each patient describes an ICD shock differently. Some say it feels like a thump on the chest while others compare it to being kicked in the chest. It is normal to feel apprehensive, but also remember that a defibrillating shock from an ICD can be lifesaving. For most people, if there is pain, it quickly passes.
Some physical activities may be restricted depending on your medical condition or concerns about physical stress on your ICD. Consult with your doctor about activities to avoid, if any.
Your doctor will determine what conditions will trigger an alert. Ask your doctor to explain what the alerts mean in your particular case. The beeping tone is designed to get your attention, not to alarm you. If you hear beeping tones from your heart device, call your doctor for instructions. The alert sounds will continue until your doctor checks your device at the clinic and programs the alert off.
Wherever you travel, your heart device monitors your heart and provides therapy whenever it is needed. You can travel knowing that support for your heart device is available around the world. Your doctor may also be able to check your heart device remotely, so it may be a good idea to let your doctor know when and where you will be traveling.
Some heart problems do run in families but that does not mean all family members will have the same problems or need the same type of therapy. Be sure to talk to your doctor for more information.
Long-term monitoring of ICD performance has shown that defibrillating a patient in sudden cardiac arrest is 98% effective in stopping the Sudden Cardiac Arrest (SCA).1,2
References:
1- Zipes DP, Roberts D, for the Pacemaker-Cardioverter-Defibrillator investigators. Results of the International Study of the Implantable Pacemaker Cardioverter-Defibrillator: A Comparison of Epicardial and Endocardial Lead Systems. Circulation. July 1, 1995;92(1):59-65.
2- Volosin, et. al. Virtual ICD: A Model to Evaluate Shock Reduction Strategies. Heart Rhythm. 2010;May Suppl:PO3-125.
Leads are placed in the hostile environment of the human body, making it hard to predict longevity. Your doctor will regularly monitor your device and lead function for any signs of malfunction.
Most likely, you will not hear anything before a shock. If an ICD senses an event that requires a shock, it responds immediately, leaving no time for any warning signals.
Your ICD is designed to deliver therapies that progress from the mildest form to be effective to an actual shock. If you receive a shock from your ICD, you will feel an obvious electrical jolt to your body, but each patient describes an ICD shock differently. Some say it feels like a thump on the chest, while others compare it to being kicked in the chest. It is normal to feel apprehensive, but also remember that a defibrillating shock from an ICD can be lifesaving. For most people, if there is pain, it quickly passes.
If you receive a shock during intercourse, stop and notify your doctor just as you would if it happened during exercise. Your partner will not be hurt by the shock. He or she may feel a tingle or a slight muscle spasm, but nothing more.
You will probably not need new leads. However, your doctor will test your existing leads before, during and after your surgery. If tests indicate that it’s time for new leads, they will be replaced along with your ICD.
Most likely not. An ICD replacement is usually same-day surgery unless your surgeon replaces or adds a new lead. Then you may spend a day or two enjoying hospital food.
No. ICDs are designed for one-time use, and we wouldn’t recommend reusing one in another person, or even an animal.
Why? First of all, it’s illegal under U.S. Federal Law. It’s also impossible to guarantee removal of body fluid or tissue from the device, meaning a bad reaction is possible even after resterilization.
Typically, the leads are reused with the new heart device. If the existing leads cannot be reused, they will stay in the body and new leads will be implanted. In certain situations, the doctor may recommend a lead be removed and replaced with a new lead. The lead removal procedure is usually performed by a doctor who specializes in lead extractions.
Your ICD has replacement time indicators, such as lower battery voltages. These give your doctor plenty of time to schedule a replacement before the battery runs out. Continue regular follow-up visits so your doctor can monitor your condition and device operation.
The majority of your ICD consists of the battery and capacitor (the component that stores and delivers charges). A smaller portion consists of the device’s electronics.
Pressure ratings can vary among ICD models. Typical diving depths can range from 50 to 100 feet. Always check with your doctor about scuba diving restrictions.
Full body imaging scanners (also called millimeter wave scanners and 3D imaging scanners) are used in airports, courthouses, prisons and other public facilities. Your ICD is not likely to be affected because the scanning takes only a short time.
Phones, which use wireless signals, have electromagnetic fields around them. Some of these fields may affect the normal operation of your heart device. Your phone should be kept at least 6 inches away from your device. When using a mobile phone, it is best to hold it to the ear that is farthest away from your heart device. Also, is a good idea to avoid carrying your phone in a shirt pocket that is close to the ICD.
No, your phone should be kept at least 6 inches away from your device. Cell phones, which use wireless signals, have electromagnetic fields around them. Some of these fields may affect the normal operation of your heart device. When using a mobile phone, it is best to hold it to the ear that is farthest away from your heart device.
Aviation transponder receivers are used to track the location of an aircraft. They are designed to receive signals only from aircraft transponders and pose no threat to your ICD.
Wireless battery chargers that don’t require an AC plug-in are used to charge items such as cell phones, music players and tablets. When using this type of charger, keep at least 6 inches between the charger and your ICD.
For some electric vehicles, there may be safety precautions when charging the battery. For example, you may not be able to sit in the vehicle while it is charging. Check with the car’s manufacturer for guidelines.
Cosmic rays consist of high-energy radiation that strikes the earth from space. Most of these flares and rays are absorbed in the atmosphere and are unlikely to affect an ICD once they reach the ground.
If you receive a therapy shock, anyone touching you may feel the shock as a muscle spasm or a tingle, although it is unlikely. A therapy shock can be startling, but it will not hurt a person touching you.
No. You will not receive a warning from your ICD before a shock. However, you may have symptoms that tell you a shock may be imminent.
Symptoms may include dizziness, lightheadedness, or a fluttering in the chest.
There are no known foods that interfere with your ICD. That means you can’t use your device as an excuse to avoid eating your vegetables. Talk with your doctor about any other dietary questions or concerns.
Yes. You can work on your car as long as there is no medical reason to avoid working around engines. You should, however, keep at least 12 inches between your ICD and parts of the car’s ignition system.
Check with your doctor about any restrictions. Some doctors do recommend limiting use of the arm that is on the same side as the ICD. The surgical site may be sensitive after the implant procedure and need time to heal for a number of days. However, after a while, you should be able to resume activities that you were doing before getting the device. Tennis anyone?
You may walk through security devices and they should not affect your ICD. Simply walk through the area at a normal pace, but don’t stand or linger nearby. Always carry your heart device ID card. This card is helpful if your heart device sets off a metal detector or a security system. If a handheld wand is used, ask security personnel to avoid holding it over or waving it back and forth over your heart device.
There are no risks from using a heated car seat because there is at least 6 inches between the seat’s electrical components and your ICD. So continue to enjoy this small luxury during the winter months.
A momentary shock will not permanently damage your ICD. A memorable (longer) shock may cause some ICD settings to be reset to nominal values. Your doctor can restore your individual settings in the clinic.
You don’t need to give up cattle rustling if you have an ICD. Both line-powered and battery-powered electric fences pose low risk because they are energized for a very short time – about once a second. If you accidentally touch an electric cattle fence, the momentary shock will be startling, but it will not permanently damage your ICD. The shock may temporarily prevent the pacemaker capabilities of the ICD from sensing a slow heart rhythm.
Hoover Dam policy recommends that people with implanted ICDs do not tour the dam because of its 60Hz magnetic field. The magnetic environment within other hydroelectric plants, however, may differ so check with them to see what their policies are for people with ICDs. Being around such strong magnetic fields may result in your ICD delivering an inappropriate shock. Tour a non-hydroelectric dam if you want to see how great quantities of water are held back through the marvels of human engineering.
While it is possible for frozen shoulder (adhesive capsulitis) to occur with ICD implants, it is unlikely. Performing gentle arm motion during the healing process will likely prevent this condition from occurring.
Temporarily limiting certain arm movements can help with healing and also prevent dislodgement of the leads. You should be able to go back to your normal arm movements after you have healed from the surgery.
MRI equipment generates large magnetic fields and radio waves that may interfere with ICD operation. Check with your doctor to see what precautions, if any, you should follow when working around MRI machines.
Items that generate or use electricity or transmit wireless signals have electromagnetic fields around them. Some of these fields may affect ICD operation. Remember that most items used in everyday life are not likely to affect your ICD. However, if you are concerned about equipment in your work environment, ask your employer to measure electric field intensity limits that may interfere with your ICD or to hire an outside firm to do so.
Yes, you can use a urinary monitor that includes a magnet. Just remember to keep the tether magnetic strap and battery compartment of the monitor at least 6 inches away from your ICD.
Yes, electroconvulsive therapy can be performed if you have an ICD. However, because this therapy introduces electrical current into the body, there may be an effect on your ICD. If you are considering electroconvulsive therapy, please consult with your doctor first to see if there are any possible risks from the procedure on your device and condition.
A colonoscopy is an exam that uses a tiny video camera to look for abnormalities in the large intestine. A colonoscopy can be safely performed on patients with heart devices. Sometimes during the exam they may use electrocautery to remove polyps. In this case, the doctor performing the procedure would need to take precautions while using the electrocautery.
Ischemic cardiomyopathy (CM) is the most common type of dilated cardiomyopathy. In ischemic CM, the heart’s main pumping chamber, the left ventricle, has been damaged by a lack of blood supply to the heart. This is usually caused by a heart attack or coronary artery disease (CAD). The result is an enlarged, dilated, and weakened heart that cannot adequately pump blood through the body.
ICDs are completely compatible with catching some Zs. Right away, it might be uncomfortable to sleep on your implant side, but over time it becomes a breeze. If your device is pacing you, that also may take some getting used to. If, after some time, the lack of sleep has you off your rocker you should really ask your doctor. If you find yourself in the terrifying reality of speaking exclusively in rhyme, seek immediate attention from an English teacher.
Because the remote monitoring systems can potentially warn your doctor of changes in your condition, resulting in early intervention within hours or days of the change, it is recommended that the remote or app-enabled monitoring be available as much as possible. If you don’t currently have remote or app-enabled monitoring set up, ask your clinic about using it. They will work with your ICD manufacturer to get you enrolled.
Riding a motorcycle is considered a low-risk activity and so it is usually permitted. However, this may vary depending on any medical conditions you have and your applicable driving laws, so do consult your doctor first.
Skiing will not interfere with your device, but do speak with your doctor before you start schussing. While many patients go back to their favorite activities-after a full recovery, of course-there are activities that cause concern.
After you’re healed from the implantation, no, it should not hurt to get a hug. If you ever do feel lingering pain or discomfort around your device, call your doctor.
Ouch! Lets hope that doesnt happen. But if it does, there shouldnt be any interference with your ICD. Still, you might want to get that jellyfish sting checked out.
Yes. Riding on a train or tram poses a very low risk of interference with an ICD. However, we recommend talking to your cardiologist before your journey up the mountain, as there are lower oxygen levels at high altitudes.
Yes, in all states, you’re obligated to report that you have an implanted device. Discuss this with your doctor or nurse and they can help you figure out how to do so.
You may notice a slight bulge under the skin where an ICD is implanted. This is normal. How it looks depends on the size of the device, size of the patient, where it’s implanted and other things.
Exposure to pressures greater than 4 ATA is not recommended. That means diving no deeper than about 100 feet or 30 meters in seawater. Talk to your doctor about that and about any other concerns with scuba diving and your heart condition.
Induction cooktops are very haute in the world of cuisine, but they do pose a concern to ICDs. Instead of heating up themselves, they use magnetic energy to heat the pan, made of steel, aluminum or copper. Therein lies the rub. Because of the magnetic fields, make sure your device is at least 2 feet away from the cooktop.
Pet shock collars for electric pet fences, including remote controls and bases with antennas, should be kept six inches away from your heart device. Buried wires should be at least 12 inches from your ICD.
Heart devices such as ICDs are very tough and in normal day to day activities shouldn’t require any extra protection. However, if you would prefer to have an additional layer of protection there are a number of options available and these can be found on our ICD Protection page.
Electromagnetic interference has only a temporary effect on ICDs. Once the device no longer detects the EMI, it will resume normal function. Don’t hold magnets within 6 inches of your device because that can temporarily disable the defibrillator.
Yes. Lasers are light energy and shouldn’t mess with your ICD. However, some magnets or transmitters in laser tag vests may interfere with your ICD, so keep it 6 inches away from your device.
Sorry, you can’t. The heart conditions for having an ICD, or even the ICD implant itself, will disqualify you from getting a pilot’s license. You can find more information in the FAA Guide for Aviation Medical Examinars.
Most industrial settings won’t interfere with an ICD, but some might be more dangerous than others. A vague answer? Sure-but to be fair…it’s a vague question. Discuss the specifics with your doctor.
If you get an ICD, you may notice a number of changes after implantation. Some people have more energy because the device is pacing their heart and delivering therapies to help with fast rhythms.
Much like the other broom-based sport, curling isn’t likely to interfere with your ICD. Ask your doctor just to be sure, but most people return to physical activities after they’ve fully recovered from surgery. Still, any sport that involves sweeping feels like work to us.
Yes! Good idea. For a gas-powered lawn mower, just be sure to stay at least 12 inches away from the ignition system while it’s operating. We hope you win a really weird trophy.
Yes. Remember to discuss exercise with your doctor, and follow their guidelines based on your own health needs. It’s always best to ease back into a fitness routine. Walk before you jog, jog before you run, etc…
E-readers have wireless transmitters to work on data networks, so we recommend keeping them 6 inches away from your ICD. So, no, you shouldn’t fall sleep with them snuggled up close. That’s getting a little too attached to your technology anyway.
Airbags are great-most of the time. Unfortunately, the speed and force of airbag delivery might pose a danger to ICD patients. It likely will not damage the device itself, but there may be a danger of lead dislodgement. It just depends on your size, the type of car, and the type of airbag. Nonetheless, the immediate threat is the car accident, so it is a good tradeoff.
Yes, coffee is generally safe in moderate amounts. Caffeine is a natural stimulant and can cause an increase in your heart rate, but moderate amounts should not be enough to cause any problems with your device.
Items that contain magnets, such as bingo wands, mechanics extractor wands, magnetic bracelets, clasps, or chair pads, magnetic therapy products, stereo speakers or earphones, and handheld massagers can temporarily affect the operation of your implanted heart device. We recommend you keep items containing magnets at least 6 inches (15 centimeters) away from your device.
Totally. Get your oral hygiene on. As with most electronic devices, we recommend keeping the toothbrush and its charging base at least 6 inches away from your ICD.
Definitely. An ICD isn’t an anchor, literally or metaphorically. Just remember that you may feel restricted when extending your arm for a few weeks after surgery. It is still a good idea to swim with a partner, if needed.
You’re going to do some exploding? Very cool. Blasting caps themselves won’t interfere with an ICD-just use caution with blasting caps that use electricity to ignite. Any electrical current that enters your body could be dangerous.
It often helps to talk with other people who have a heart device and ask them how they have adjusted to it. Ask your doctor or nurse if there is a support group for heart device patients at your clinic or a nearby hospital. Sometimes your healthcare team will recommend cardiac patients to mental health professionals. Your doctor or nurse will likely have referral sources available that can assist in stress management and adjustment to living with an ICD.
It’s important for any healthcare provider you see to know about your implanted devices, as well as the medical conditions that relate to them. It’s simply in your best interest. Lots of people find their ID card to be a good icebreaker when starting a conversation with a new doctor, clinician, or dentist.
Yes, you can use mobile phones. However, mobile phones may cause electrical interference with your heart device when the phone is turned on and held too close to your heart device. Also, some accessories for mobile phones contain magnets that may cause interference, such as earbuds or cases with magnetic clasps. Any effect is temporary, and simply moving the phone or accessory away will return the heart device to its previous state of operation.
Welding with currents above 160 amps may temporarily affect normal ICD function. Check with your doctor. They might not know much about welding, but they can talk to you about interference with your ICD. Note: Aprons or vests will not effectively shield the ICD from the electromagnetic energy generated by welding equipment. Follow these safety precautions to avoid interference:
Get your yard maintenance on. It’s fine to use a powered lawnmower as long as you keep some distance between the running mower and your ICD. For electric motors, stay 6 inches away. If you’re using a gas-powered mower, keep the ignition (spark plug area) at least a foot away from your heart device.
You shouldn’t have any problem hunting with an ICD, but there are a few things to be aware of. Before implantation, ask your doctor if you can have the device placed on the side you don’t shoot with. If that’s not possible, you can always learn to shoot with the other hand. If you use a rifle or shotgun, rest the butt on the shoulder opposite from your heart device. Happy hunting!
Security badge scanners shouldn’t give you anything to worry about. Keep the badge and scanner at least 6 inches away from your ICD and you’ll be fine.
The decision to drive after getting an ICD depends on your medical condition and the laws in your area. Your doctor will look at your electrophysiology (EP) tests, how you’re responding to the ICD and its therapies, and any other medications you take. The one exception that definitely requires a conversation with your doctor is being a commercial driver like a bus driver or truck driver.
There might be. It depends on what your work environment is like. After receiving an ICD, you may need to be more careful while using electrical tools, appliances, or other big fancy machinery, in order to avoid device “cross-talk” called electromagnetic interference.
Sure. Get glamorous, but keep the hair dryer at least 6 inches away from the device. That’s for handheld hair dryers at home. Those salon style ones you sit under won’t affect an ICD.
ICDs are to help you live better, not limit you. There might be a few lifestyle adjustments you need to make, but you should be able to resume most activities once your doctor has confirmed that your incision has healed.
A polygraph poses a low risk to the ICD, and the ICD poses risks to the accuracy of the polygraph. If the pacemaker feature is delivering stimuli to your heart, the heart rate parameters of that lie-detecting might not be so valid.
When a recall is issued on an ICD, manufacturers always notify every doctor that uses their devices-sometimes the manufacturer notifies the patients as well. It depends on what the Physician Quality Panel and the FDA recommend.
If an external defibrillator or AED must be used, it should be used. However, it may change the settings or damage your ICD. If external defibrillation or AED is used, the implanted device should be checked for proper settings afterward. Consult your doctor if you ever get defibrillated externally.
Don’t be all pins and needles about this one. Acupuncture is no problem, as long as it’s not acupuncture with an electrical stimulus. Electrical stimulus could be detected by your ICD, potentially resulting in an inappropriate shock.
Your doctor will prescribe a schedule of post-implant checkups, and they’ll just become a regular thing. At each one, the clinician will use a gizmo called a programmer that communicates with the computer chip in your ICD to check it out. It’s very simple, and it helps ensure that your device is meeting your needs, no slacking off. Often these checkups can be done at home with remote monitoring.
ICDs deliver shocks to save your life when pacing therapies don’t return your heart to a normal rhythm. After a successful shock, your normal heart rhythm will resume.
ICDs vary in size, depending on type and model. But if you’d like to bust out your ruler, the average ICD size is 2.5 inches high x 2 inches wide x 0.5 inch deep (or 64mm x 51mm x 13mm).
Let your doctor know if you’re worried. Allergy testing can be done – and if you need a custom device, they can order one with special coatings to prevent allergic reactions. An allergic reaction to the ICD is very rare.
Your doctor plays matchmaker to set you up with the device that you’ll get along with the best. They’ll consider the device features as well as your medical condition. If you have a preference, discuss this with your doctor before the day of your surgery.
The outer layer of an ICD is usually made of titanium. Titanium is considered the most attractive material for biomedical applications and is used in many different kinds of implantable medical devices such as artificial hip and knee replacements, artificial hearts, dental implants, and many others.
Currently, there aren’t any companies that make an ICD specifically for children. A regular ICD will perform correctly when programmed for a child, and might be implanted differently for the child’s comfort.
Yes. An ICD can be turned off, but only by a doctor’s orders. This is typically done only when a person is preparing for death, usually due to another cause.
The longevity of your ICD depends on how often it is used, and how it’s programmed. The typical range is 4-12 years. Say “What’s up?” to your doc for more specifics.
ICDs are commonly tested for device performance and battery life. This way, you’ll know that your device is programmed correctly and when it’s ready for replacement.
It’s normal to be a little anxious about getting a heart device. We would probably be a little worried if you weren’t. But the best weapon against anxiety is information, and you’ve obviously come to the right place.
Before your ICD implant, ask that doctor of yours what medications you’re allowed to take. It might be necessary to stop some of them before the procedure. For example, it’s common for people with diabetes to adjust their medications.
An ICD can be programmed to deliver several types of therapies. They can act as a standard pacemaker, deliver high-energy shocks, and deliver rapid pacemaker-like therapy to break up fast heart rhythms.
An ICD is made up of a small titanium can and at least one soft insulated wire lead. The titanium can holds the electronics, a built-in lithium battery and the high-voltage capacitors needed for a shock. The leads carry electrical impulses from the defibrillator to the heart, as well as information back from your heart so the defibrillator knows what it is doing..
Not really. Sedation/anesthesia is used for the procedure. You might be slightly awake, but you shouldn’t feel anything. You probably won’t remember anything either.
It usually takes about 2-3 days before you can resume everyday activities. Your doctor will tell you more, as some activities may be limited for several more weeks to allow time for a full recovery. Patience is a virtue.
You will be monitored in the procedure area/recovery room until you are fully awake. Monitoring typically includes heart rate and rhythm, blood pressure and oxygen level until you are fully awake and then, depending the facility, you may be transferred to a short-stay unit or cardiac area for several hours to overnight before being discharged.
Risks can include, but are not limited to, infection, bleeding, punctures to the lung, heart, or vein during lead insertion, swelling and bruising at the implant site. Talk with your doctors about your risk factors.
First, an incision is made just below the collarbone. Then leads are inserted and attached to the heart, and then tested to make sure they’re working right. The leads are then connected to the ICD and everything is placed under the skin. Finally, the incision is closed up and you’re all done.
Bundle branches are clusters of pathways that carry electrical impulses to different parts of your heart. A bundle branch block is a delay or obstruction in one of the pathways. These can keep your heart from pumping normally. Many blocks are caused by heart disease, some are there at birth. If the condition is serious, a pacemaker may be prescribed.
Bradycardia is a condition in which the heart beats too slowly. A healthy heart beats 60 to 100 times per minute, pumping about 75 gallons of blood every hour. With bradycardia, the heart beats fewer than 60 times per minute. At that rate, your body doesn’t receive enough oxygen-rich blood to fuel exercise or even just normal activity. As a result, you might feel dizzy, tired, short of breath, or have fainting spells.
Antitachycardia pacing (ATP) is an ICD therapy often used to treat ventricular tachycardia (VT). If the heart rhythm starts to accelerate, ATP means the ICD will deliver small but quick, low-energy pulses to pull it back. Some patients may feel symptoms of VT, such as dizziness and lightheadedness, but for many, ATP is so fast and painless, they don’t even notice the episode. As long as a normal rhythm is restored, no further treatment is needed. How slick is that? ATP is activated at your doctor’s discretion.
Traditionally, a pacemaker is used to help treat a slow heart rate, a condition known at Bradycardia. An ICD is implanted to help treat tachycardia-a fast heart rate-or when there’s risk of Sudden Cardiac Arrest (SCA). Now they’re both found in the same device.
During a DFT, or defibrillation threshold test, your doctor will put your heart into a fast rhythm, then watch the device deliver therapy to restore proper rhythm. This helps the doctor determine how to program the ICD to respond and possibly save your life when you really need it.
You know it better as a pacemaker. An implantable pulse generator provides timed electrical stimuli to the heart. It’s one part of a three-part system: the pacemaker with the electronics and power source, your heart, and the leads that connect the two.
An atrium isn’t just a nice big room with a glass roof. It’s also the medical term for one of the upper two chambers of your heart. If you’re referring to both of those upper chambers ”atria.”
An ICD can have one or two wires, called leads, depending on what your heart needs. One lead goes in the right ventricle, and if you need a second lead, it will be placed in the right atrium. A CRT-D system adds a third, attaching a lead to the left ventricle so it can help both sides beat in synch and thus pump more efficiently. If you’ve experienced heart failure, you’ll most likely get a CRT-D.
Having an ICD, in combination with a complete program of therapy, has proven to improve quality of life for many patients. It can reduce the symptoms of heart failure, increase exercise capacity and allow individuals to resume many daily activities.
Around 60,000 people receive CRT implants in the U.S. each year. That’s almost twice the population of Walla Walla, Washington. (So it’s pretty common.)
A CRT-D device delivers cardiac resynchronization therapy, which helps coordinate your heart rhythm so that your body gets the blood and oxygen it needs.
Here are just a few genetic heart conditions that may put someone at risk of a sudden cardiac arrest and require an ICD: Brugada Syndrome, Arrhythmogenic Right Ventricular Dysplasia (ARVD), Long QT Syndrome, and different types of Cardiomyopathy (disease of the heart muscle).
Causes of an arrhythmia include heart disease, scarring of the heart muscle, congenital conditions, genetics, high blood pressure, diabetes, alcohol or tobacco use, stress, some medications, or the onset of a heart attack.
An arrhythmia is an electrical malfunction of the heart causing an irregular heartbeat. It can be too fast, too slow, or erratic. Often they’re very brief. If they last longer, the heart could start pumping less effectively. This can often be corrected by a pacemaker, ICD, and/or medications. An arrhythmia is not a heart attack.
Ventricular fibrillation is an exceedingly fast heart rate in the ventricles, the pumping chambers of your heart. When the ventricles are beating too fast, they start to quiver and can no longer pump oxygen-rich blood to the body and brain. If not treated promptly, ventricular fibrillation can lead to death. ICDs are primarily designed to treat ventricular fibrillation and other life-threatening arrhythmias.
Atrial fibrillation (AF or AFib) is a common type of heart rhythm disorder affecting the atria, the upper chambers of the heart. It occurs when the atria quiver instead of contracting normally. Atrial fibrillation increases a person’s risk for stroke.
Heart failure is when your heart cannot pump hard enough to keep blood flowing throughout your entire body. Heart failure is assessed by a measure known as ejection fraction (EF), or the volume of blood ejected with each heartbeat.
Hut-hut-hike yourself to your heart’s content. Football probably won’t interfere with your ICD, and most people resume physical activities after recovering from surgery. The potential for tough contact is a concern to talk with your doctor about but can likely be avoided with your sweet moves!
Yes. Fitbit trackers and other similar products have a low probability of interfering with your ICD, but we recommend keeping it 6 inches away from your device if it contains a magnet.
Intimacy is a normal part of life. We understand patients resume sexual activity when they feel comfortable. However, if you have a question, it may be helpful to have a conversation with your doctor. If in doubt about an activity, always discuss it with your doctor or nurse.
A combination of several factors may put people at risk for a life-threatening arrhythmia. This includes prior heart attacks, reduced heart function, advanced heart failure and spontaneous VT or VF that is not due to a transient or reversible cause.
An ICD monitors a person’s every heartbeat around the clock. If the heart rate is too fast or too slow, the ICD automatically sends small, painless electrical signals to correct it. If that doesn’t do the trick, the defibrillator delivers a shock to restore the heart to a normal rate.
Wherever you travel, your heart device monitors your heart and provides therapy whenever it is needed. You can travel knowing that support for your heart device is available around the world. Your doctor may also be able to check your heart device remotely, so it may be a good idea to let your doctor know when and where you will be traveling.
An overnight stay in the hospital is common. Most patients return to most normal daily activities within 2-3 days following surgery. It is not uncommon to have some soreness and tenderness at the incision site for several days. Bruising may also be noted at the surgical site. Incisional healing usually is complete within 7-14 days. There may be a lifting and activity restrictions placed by your physician for several weeks following your surgery to allow for complete healing.
Sudden Cardiac Arrest (SCA) symptoms are immediate and dramatic and can include a loss of consciousness, sudden collapse, no breathing and no pulse. Sometimes other symptoms can occur before a sudden cardiac arrest. These symptoms may include fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath, weakness, palpitations or vomiting. But often sudden cardiac arrest occurs with no warning.
Tachycardia is a word for any abnormally fast, irregular heart rhythm, in some cases up to 400 beats per minute. This makes it difficult for the heart to pump blood to the rest of your body.
A magnetic resonance imaging (MRI) scan is a type of diagnostic that creates an internal view of your body. The energy fields present during an MRI scan may harm a traditional heart device, which could endanger a patients health.
Ask your doctor about this one before you ride. Some coasters restrict people with heart conditions. Other times shoulder harnesses can be very uncomfortable on the implant site, or even cause damage.
Sudden Cardiac Arrest (SCA) can happen when the lower chambers (ventricles) of the heart beat very fast and irregularly, causing the heart to stop because it can’t handle the pace. SCA is the leading cause of death in the United States, claiming more than 350,000 lives each year. Approximately 92% of those who experience SCA do not survive. Defibrillation using an Automated External Defibrilator (AED) or an Implanted Cardioverter Defibrillator (ICD) is the most effective treatment for Sudden Cardiac Arrest.
Electrophysiologists (EPs) specialize in treating electrical disorders in the heart. ICDs and CRT-Ds monitor and treat certain electrical problems in the heart. Many EPs perform implant procedures and conduct follow-up device checks for patients with heart devices.
A cardiac arrest usually happens without warning. If someone is in cardiac arrest, they collapse suddenly and:
will be unconscious
will be unresponsive and
won’t be breathing or breathing normally – not breathing normally may mean they’re making gasping noises.
Without immediate treatment or medical attention, the person will die. If you see someone having a cardiac arrest, phone for help immediately and start CPR.
A heart attack is when one of the coronary arteries becomes blocked. The heart muscle is robbed of its vital blood supply and, if left untreated, will begin to die because it is not getting enough oxygen.
A cardiac arrest is when a person’s heart stops pumping blood around their body and they stop breathing normally.
Many cardiac arrests in adults happen because of a heart attack. This is because a person who is having a heart attack may develop a dangerous heart rhythm, which can cause a cardiac arrest.
A heart attack and a cardiac arrest are both emergency situations. Call the emergency services straight away.
The simple answer is yes, but usually only temporarily.
The length of the period that you cannot drive for is mainly dependent on the cause of your cardiac arrest and the remedial action taken.
For example, if you had a heart attack as the cause and you had stents and medications to prevent future episodes then the period to stop driving would typically be 1 month.
If you had to have an ICD fitted then the period that you had to stop driving would typically be 6 months from the date of the implant – not the date of the cardiac arrest
You will need your driving licence number, national insurance number and postcode.
You can see details about who the licence is for when it is valid from/to, the current status, what vehicles you can drive, any penalties or disqualifications.
The official advice is that you should inform your insurance company of your heart condition and implant (ICD/pacemaker) if you have one.
However, from our members experience most insurance companies do not seem to be interested in the fact that you have had a cardiac arrest. If you have a valid licence to drive then they are generally happy to take your money and insure you.
Of course, if you are on a prolonged suspension and your car isn’t going to be used you may wish to speak to them to alter your level of cover and potentially save a few pounds.
If at any time you receive an appropriate shock from your ICD i.e. one that is correcting a potentially fatal arrhythmia, you must surrender your licence and stop driving for 6 months.
If you were incapacitated i.e. went unconscious whilst you received the shock the suspension is 2 years. This may be reduced to 6 months if your cardiologist takes steps to prevent any further events requiring a shock eg starting or adjusting medications.
If you receive an inappropriate shock i.e. the shock was unnecessary, then you will receive a 1 month suspension.
If you are driving whilst you receive a shock you should stop as soon as is safe to do so, and should not continue until the cause of the shock has been investigated.
Once you have mailed this you will receive a letter from DVLA stating that they have written to your consultant with an expected 6-week turnaround. You do not need to do anything further other than call them back on several occasions as this part of the process takes a long time!
The DVLA will send your cardiologist forms to get more information about your cardiac status. Your cardiologist will need to sign these forms to say they should issue you with a licence. This all takes time, and it’s a good idea to chase your cardiologist to make sure you’re not forgotten.
It’s also worth starting the process a good 8 weeks before the date your period of driving restriction ends.
If your licence was revoked, as opposed to voluntarily surrendered, you may find that the process to get your licence back longer and more arduous.
In the SCA UK Facebook Group we are seeing an increasing number of members who get their licence revoked when they voluntarily surrender it.
At this time it is not clear why this happens as we have seen members with apparently similar circumstances have different outcomes.
The DVLA can revoke your licence on medical grounds and it may be the differences in the details that they make their decision but for now, it is a bit of a mystery.
Our only advice would be to not use the online form but as soon as possible fill in the paper forms and send in your licence stating that you are voluntarily surrendering your licence. This is because anecdotal evidence from the group indicates that if you use the online form it appears you’re more likely to get your licence revoked.
Remember if your license is revoked you cannot use Section 88 rules to drive until your license is reinstated.
You’ll need to enter details about your current driving licence and your condition. You might also need to give your GP’s name and address.
How this will affect your ability to drive will depend on what the cause of your cardiac arrest was, any remedial treatment you have had and any subsequent or other conditions you have.
The date of your suspension will usually start from the date that you have any remedial work or get a formal diagnosis of a condition, not necessarily the date of your cardiac arrest.
For example, if you have a cardiac arrest and 2 weeks later get an ICD implant, then the suspension will start from the date of the implant, not the arrest.
If you have a heart attack as the cause of your cardiac arrest, the problem is often looked at and dealt within a short time frame (same day) so the suspension will start from that day.
It will largely depend on your individual circumstances and medical conditions but common suspension periods are as follows:
If you had a heart attack as the cause of your cardiac arrest and it was remedied with medications and/or stents then the suspension period is 1 month.
If you had to have an ICD fitted then the suspension period will be 6 months from the date of the implant. If you have any shocks further suspensions will apply and the length will vary depending on a number of factors. See “Can I drive if I get a shock from my ICD” for more information.
You may also have to temporarily stop driving if your anti-arrhythmic medications are changed, typically for 1 month.
If your driving licence was revoked you’ll have to wait until all medical enquiries are complete. You will also need to have your driving licence back before you can start driving again.
Many of the conditions listed will mean that there will be some period of suspension, but you may be allowed to drive again if you can meet certain conditions including assessment by a specialist cardiologist.
However, if you have an ICD implanted you will not be able to drive an HGV or commercial vehicle.
The length of your suspension can vary depending on a number of factors including but not limited to cause of your cardiac, remedial actions taken, subsequent or other conditions.
It may seem tempting to compare one person’s case with another but it is often difficult to do so because of not having the full facts about a person’s situation.
If you are unable to drive because of your cardiac arrest and you are in a position to return to work, you may apply for the “Access to Work” scheme which may help with other transport costs, such as public transport or even private taxi’s.
For example, a member of SCA UK who was a teacher when she had her SCA was unable to return to work because she had an ICD fitted and this meant a driving suspension period of 6 months. She lived in the country and there was no suitable public transport to get her to her school. The “Access to Work” scheme gave her a grant to allow her to get a taxi to and from her place of work.
If you can get to work by public transport you might be able to get reduced price travel such as a Disabled Person’s Railcard. If your licence has been revoked for medical reasons, you are entitled to a free bus pass in most areas. In Northern Ireland, you can get a SmartPass giving you half price travel. In London, you can get a Freedom Pass. Apply through your local council.
If you are worried about the safety of someone’s driving, it can be a tricky subject to talk about. But it’s vital to make them aware of your concerns, not just for their safety, but for the safety of others on the road.
If a person has been driving for many years it can be hard to suddenly stop, and it can change the way they see themselves. So they may need support and guidance from family, friends and professionals.
Sometimes survivors find it difficult to recognise the effects of the event. It can also affect your judgement and, in rare cases, someone can be unaware they have a disability. This is called anosognosia.
Family members and professionals may need to remind them that they can no longer drive because of the potential risk to themselves and others. You could read this together and talk about the other ways of getting around, and plan some of the journeys they might want to make using alternative types of transport.
If you feel that the person is not safe to drive and they refuse to stop driving, you can write to the DLVA in confidence online.
If you are able to return to driving, the choice of when and how to do it is a personal one.
If you have an occupational therapist, talk to them about it. They can tailor your therapy to help prepare you to return to driving. An automatic car can be easier to drive than a manual.
Before you start driving again, you may find it helpful to have a few refresher lessons with a qualified driving instructor. You can find driving instructors in your area by looking in your local phonebook or on the internet. Check that they are registered with the Driving Standards Agency (DSA). Mobility centres can also provide advice about returning to driving.
Insurance Before you start driving again you must tell your insurance company about your cardiac arrest and any medical conditions you have. If you don’t do this, it might invalidate your insurance. Insurance companies have their own processes, so talk to yours to find out more. Check your policy carefully. They might want confirmation that you are safe to drive.
Having a medical condition can make insurance more expensive. Try shopping around for a competitive quote, or look for a specialist insurance provider when you need to renew.
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