FAQ

No, not in normal circumstances. Your ICD is programmed to deliver therapy only above a specific heart rate threshold, set well beyond what ordinary vigorous exercise produces. Raising your heart rate through exercise will not trigger an inappropriate shock.

Your device clinic takes your activity levels into account when programming the device, so tell them if you are returning to running, cycling or other demanding exercise. If you are ever shocked during or after exercise, stop, rest, and contact your device clinic or cardiology team the same day so they can review what the device recorded.

Most people with ICDs exercise regularly and without issue. The bigger barrier is usually confidence rather than the device itself, and that improves with gradual, consistent activity.

Category: Implantable Devices

No, not in the conventional sense. This is the most clinically important difference between an S-ICD and a standard transvenous ICD.

An S-ICD can deliver brief post-shock pacing — a short burst of pacing in the seconds immediately after it has delivered a defibrillation shock, to prevent the heart pausing dangerously in that window. But it cannot provide ongoing bradycardia pacing (pacing that keeps the heart from beating too slowly on a continuous basis) or anti-tachycardia pacing (ATP, which is rapid pacing used to interrupt a fast heart rhythm before it needs a shock).

This means an S-ICD is not appropriate if:

• You have a slow heart rate that requires a pacemaker to maintain an adequate rate
• You have a type of fast heart rhythm that can be reliably terminated with ATP, which is less painful than a full shock

Some patients who need both ICD protection and pacing have an S-ICD combined with a separate leadless pacemaker (such as the Micra device), which sits inside the right ventricle and handles pacing without transvenous leads. This combination is used in selected cases where both subcutaneous defibrillation and pacing are needed but traditional transvenous leads are undesirable. Your electrophysiologist will determine which configuration is right for you.

Category: Living With an ICD

An S-ICD is considered when someone needs ICD protection against life-threatening arrhythmias but does not currently require ongoing pacing therapy. It tends to be particularly well suited to:

• Younger patients, where avoiding transvenous leads reduces lifetime exposure to the complications those leads can cause over decades of use, including fracture, infection, and the need for lead extraction procedures
• People with congenital heart disease or unusual cardiac anatomy, where placing transvenous leads is technically difficult or carries higher risk
• Patients at elevated risk of device infection, where keeping leads out of the bloodstream reduces the chance of serious endovascular infection
• People who have already experienced transvenous lead complications, such as lead fracture or infection, and need a different approach

Before an S-ICD can be implanted, a sensing screening test is carried out to confirm that the device will be able to reliably detect the heart’s rhythm from the subcutaneous position. A small number of patients do not pass this screening and require a transvenous device instead. Your electrophysiologist will assess which type of device is most appropriate for your individual situation.

Category: Implantable Devices

A standard ICD uses leads that travel through a vein into the heart chambers, where they sense the heart’s rhythm and deliver shocks if needed. A subcutaneous ICD (S-ICD) does not enter the blood vessels or the heart at all. Instead, the lead is tunnelled just under the skin, running alongside the breastbone, and the device generator is implanted under the skin on the left side of the chest, below the armpit.

Because there are no leads inside the heart or blood vessels, an S-ICD avoids several risks associated with transvenous leads: lead fracture within the bloodstream, damage to heart valves, and bloodstream infections (endocarditis). It is also generally easier to remove if the device ever needs replacing or explanting.

The most important limitation of an S-ICD is that it cannot deliver ongoing pacing therapy or anti-tachycardia pacing (ATP). It can only detect a dangerous rhythm and deliver a shock. If you need continuous pacing — because your heart rate is too slow, or because ATP is part of your arrhythmia management — an S-ICD would not be appropriate on its own. This distinction is assessed before a device is chosen.

Category: Treatment

Your device clinic monitors CRT-D function at regular check-ups, just as with a standard ICD. They use a programmer to review pacing data, check battery levels, assess how much of the time the device is delivering biventricular pacing (the percentage pacing figure), and adjust settings if needed. Remote monitoring between appointments allows the clinic to track this data without a visit.

From your perspective, CRT often produces noticeable improvements over weeks and months after implant: reduced breathlessness, better exercise tolerance, and less fatigue. These changes can be gradual rather than immediate. Response to CRT is not universal — roughly one in three patients does not experience the expected benefit, sometimes because the lead positioning is not optimal or because of underlying heart anatomy. If this appears to be the case, your clinic may adjust settings or consider lead repositioning.

If your symptoms worsen after a CRT-D implant rather than improving, or if you receive a shock, contact your device clinic or attend A&E. As with any ICD, any shock should always be reviewed.

Category: Implantable Devices

A CRT-D is recommended when someone needs both ICD protection and cardiac resynchronisation therapy. This typically applies to people with heart failure where:

• The left ventricle’s pumping function is significantly reduced (usually an ejection fraction of 35% or below)
• The ECG shows a wide QRS complex, indicating that the two ventricles are not contracting in synchrony
• Symptoms persist despite optimal medical therapy

In this group of patients, biventricular pacing can improve symptoms, exercise capacity, and quality of life, and in some cases can partially reverse the structural changes in the heart. Clinical evidence shows that approximately two in three eligible patients experience meaningful benefit from CRT.

Not everyone who has had a cardiac arrest has heart failure, and not everyone with heart failure needs a CRT-D. A standard ICD may be perfectly appropriate. The decision is made by a specialist cardiologist or electrophysiologist based on your ECG, echocardiogram results, symptoms, and other clinical factors. If a CRT-D has been recommended for you, your team will explain the specific reasons.

Category: Treatment

A CRT-D (cardiac resynchronisation therapy defibrillator) is a device that combines two functions in one: a biventricular pacemaker and an implantable defibrillator.

The biventricular pacing component (the CRT part) sends precisely timed electrical signals to both the left and right ventricles, helping them contract in better synchrony with each other. In people whose ventricles are out of step — a condition that shows up on an ECG as a wide QRS complex — this can significantly improve the efficiency of the heart’s pumping action. The defibrillator component works exactly like a standard ICD: it monitors the heart rhythm continuously and delivers a shock if a life-threatening arrhythmia is detected.

A CRT-D typically has three leads rather than the one or two used in a standard ICD. The extra lead is positioned via the coronary sinus, a vein on the back of the heart, to pace the left ventricle directly. This three-lead system makes the implant procedure more complex than a standard ICD implant.

Category: Implantable Devices

This depends on what type of driving licence you hold and the nature of your role, and it is one of the most important practical questions to resolve before you attempt to return.

Group 1 licence (ordinary car): There is typically a mandatory period during which you cannot drive after a cardiac arrest or ICD implant. Once this period has passed and the DVLA has confirmed you may drive again, returning to a job that involves some driving is generally possible, subject to your cardiologist’s advice.

Group 2 licence (lorry, bus, or coach): The DVLA rules for Group 2 drivers are much stricter. Following a cardiac arrest, Group 2 licensing is usually permanently revoked, and in most cases cannot be reinstated after an ICD implant. If your job specifically requires a Group 2 licence — HGV driver, bus driver, coach driver — this is likely to mean a permanent change of role. This is one of the most significant practical impacts cardiac arrest can have on employment.

Do not drive for work until you have received explicit written confirmation from the DVLA that your licence has been reinstated or retained. Our page on driving and the DVLA after cardiac arrest covers the regulations in full. Members of our community who have navigated this process, including those who have had to change careers, are often willing to share their experience.

Category: Driving

Many people do return to physically demanding work after a cardiac arrest, but it generally takes longer than returning to a sedentary role, and a phased return with gradual increase in activity is usually advisable. Your cardiologist needs to be involved before you return to strenuous physical work.

If you have had an ICD fitted, there are additional considerations. Some industrial or manual environments involve equipment that generates strong electromagnetic fields — certain welding equipment, large motors, and power generation machinery can interfere with ICD function. Your device clinic can advise on what is and is not safe in your specific workplace. This does not rule out physical work, but it does need assessment.

An occupational health referral is particularly important for physically demanding roles. Your occupational health adviser can assess the specific risks of your job, recommend appropriate adjustments or restrictions, and liaise with your employer on a safe return-to-work plan. Some roles may require temporary redeployment while recovery continues. Our page on returning to work after cardiac arrest has further guidance.

Category: Practical Issues

It depends entirely on why your cardiac arrest happened. For some survivors, the underlying cause is identified and successfully treated, which substantially reduces the risk of recurrence. For others, particularly those whose cardiac arrest arose from an ongoing arrhythmia or structural heart condition, some elevated risk remains. This is one of the reasons an ICD may be recommended.

Your cardiologist is the right person to discuss your individual risk with. They will have assessed the cause of your arrest and the condition of your heart, and they can give you a clearer picture than any general answer can. It is a reasonable and important question to ask directly.

Living with uncertainty about recurrence is one of the harder aspects of cardiac arrest survival, and the fear of it happening again is one of the most common concerns survivors raise. It does not mean the risk is high. Many survivors find that understanding their risk, even if it is not zero, is less frightening than not knowing. Peer support from others who have navigated the same uncertainty is something our community offers in abundance.

Category: Cardiac Arrest

In most cases, yes, but not immediately. Following a cardiac arrest, the DVLA in the UK requires you to stop driving and notify them. Whether and when you can drive again depends on several factors, including the type of heart rhythm that caused the arrest, whether you have had an ICD fitted, whether you have a Group 1 (ordinary) or Group 2 (lorry or bus) licence, and whether you experienced symptoms beforehand.

For Group 1 drivers who have had an ICD fitted after a cardiac arrest due to a shockable rhythm, there is typically a period of several months before driving may be considered. The rules are complex and have been updated over time. The DVLA and your cardiologist are the definitive sources. Do not drive until you have explicit confirmation that you may.

Our page on driving and the DVLA after cardiac arrest covers this in more detail, including the relevant guidance and how to notify the DVLA. Many members of our community have been through this process and can share their experience of navigating it.

Category: Driving

For most people, life with an ICD is largely unchanged, with some practical adjustments. The ICD monitors your heart rhythm continuously and will deliver a shock if it detects a dangerous rhythm. Most of the time you will not be aware it is there.

There are a few areas to be aware of. Driving is restricted initially, and the rules depend on several factors including the type of rhythm that caused your arrest. Certain sources of strong electromagnetic fields can interfere with an ICD, though the risk in everyday life is low. Some sports, particularly contact sports, need review with your clinical team. Your cardiologist or cardiac nurse specialist will go through the specifics with you.

What many survivors find hardest is the psychological adjustment: knowing that a device is watching your heart, and wondering what it means if it activates. Many ICD recipients describe an initial period of anxiety that eases considerably with time. Our site has detailed information on living with an ICD, and our community includes thousands of ICD recipients, many of whom have been living with one for years and are happy to share their experience.

Category: Recovery

Having an inherited heart condition does not mean you will experience a cardiac arrest. It means you need the right specialist care, regular monitoring, and an informed conversation with your cardiologist about your personal risk profile.

Many people live long, full lives with conditions such as Hypertrophic Cardiomyopathy (HCM), Long QT Syndrome, Brugada Syndrome, CPVT, ARVC, and Dilated Cardiomyopathy — particularly when they are well managed. Understanding your specific triggers, adhering to any activity guidance, and taking prescribed medication consistently all make a significant difference.

Key steps if you have an inherited heart condition:

Know your triggers. Some conditions are provoked by exercise; others by sleep, sudden noise, or fever. Ask your cardiologist specifically what yours are.

Ask about treatment options. Medication, an ICD, catheter ablation, or a combination may all be relevant depending on your condition and risk.

Ensure your family is screened. Many inherited cardiac conditions can pass silently through families. First-degree relatives should be assessed even if they have no symptoms.

If you feel your condition is not being adequately monitored, ask your GP for a referral to an inherited cardiac conditions (ICC) clinic.

Category: Cardiac Arrest

Life insurance is available after cardiac arrest and with an ICD, but it will typically be more expensive than standard rates and some providers may decline certain types of cover. The market varies considerably between insurers, so it is important to shop around and use a specialist broker where possible.

When applying for life insurance, you are required to disclose your medical history, including your cardiac arrest and any devices or conditions. Failing to disclose is likely to make any claim invalid. Insurers will usually ask for details of the event, the cause, your current medications, device type, and the results of your most recent cardiac review.

Some policies may be available at standard rates, particularly if the cardiac arrest occurred some years ago, the cause has been fully treated, you have a well-functioning ICD, and there are no other significant health conditions. Others will be offered at "loaded" (increased) premiums, or with exclusions for cardiac-related claims.

For those who cannot obtain standard life insurance, options include over-50s guaranteed acceptance plans (which do not require medical questions but typically pay a fixed sum) and specialist insurers who focus on people with pre-existing medical conditions.

The British Heart Foundation produces guidance on insurance for people with heart conditions. Specialist financial advisers experienced in this area can help identify the most suitable options.

A cardiac arrest does not mean life insurance is impossible — it means you need to look harder and possibly pay more.

Category: Implantable Devices

Moderate alcohol consumption is generally considered safe for most people with ICDs, but there are some important considerations.

Alcohol can affect heart rhythm. Even in healthy people, heavy alcohol consumption can trigger atrial fibrillation ("holiday heart") and, in people with certain underlying conditions, ventricular arrhythmias. For people with inherited arrhythmia conditions such as Brugada Syndrome, alcohol — particularly in large quantities — can be a recognised trigger for dangerous arrhythmias and should be avoided or very strictly limited.

For most ICD patients, the general advice is to drink sensibly and within the recommended UK guidelines (no more than 14 units per week, spread across three or more days, with alcohol-free days). Binge drinking should be avoided.

Alcohol can also interact with some cardiac medications. For example, certain antiarrhythmic drugs and blood-pressure medications are affected by alcohol. Ask your pharmacist or cardiac team about any specific interactions with your medications.

If you are unsure what is safe for your specific condition, discuss it with your cardiologist or device clinic. They can advise based on your diagnosis, your device settings, and the medications you take.

Category: Implantable Devices

CPVT — Catecholaminergic Polymorphic Ventricular Tachycardia — is a rare inherited arrhythmia syndrome in which the heart is structurally normal but specific triggers, particularly physical exertion or emotional stress, can provoke dangerous ventricular arrhythmias. These can cause palpitations, blackouts, or sudden cardiac arrest.

CPVT is caused by mutations affecting calcium regulation within heart muscle cells, most commonly in the RYR2 gene. It typically presents in childhood or adolescence and can cause sudden cardiac arrest in young people who appear otherwise completely healthy. A standard resting ECG may be normal; an exercise stress test often reveals the characteristic bidirectional ventricular tachycardia.

Treatment includes beta-blockers to reduce the risk of arrhythmias triggered by adrenaline, strict avoidance of competitive and high-intensity exercise, and in many cases ICD implantation. Some patients are also treated with flecainide.

Because CPVT is inherited, family screening is essential following a diagnosis. First-degree relatives should be assessed with an exercise stress test as well as a resting ECG and echocardiogram, as the resting ECG may appear entirely normal even in affected individuals.

Category: Implantable Devices

Hypertrophic Cardiomyopathy (HCM) is the most common inherited heart muscle condition. In HCM, the walls of the heart — most often the left ventricle — become abnormally thickened (hypertrophied), which can obstruct blood flow, cause the heart to pump less efficiently, and create dangerous arrhythmias.

HCM affects approximately 1 in 500 people and is a leading cause of sudden cardiac death in young people, including young athletes. Many people with HCM have no symptoms at all; others experience breathlessness, chest pain, palpitations, or blackouts. In some cases, the first sign of HCM is a cardiac arrest.

HCM is caused by mutations in genes that encode the proteins of the heart muscle, most commonly MYH7 and MYBPC3. It is inherited in an autosomal dominant pattern, meaning each first-degree relative of someone with HCM has a 50% chance of carrying the same gene variant.

Treatment depends on symptoms and risk profile and may include medication (beta-blockers, calcium channel blockers), a procedure called septal reduction therapy (to reduce obstruction), and ICD implantation for those at high risk of sudden cardiac arrest.

Family screening — with ECG, echocardiogram, and genetic testing — is strongly recommended for all first-degree relatives.

Category: Cardiac Arrest

Brugada Syndrome is an inherited heart condition in which the heart’s electrical system malfunctions despite the heart having a normal structure. It is caused by mutations affecting sodium channels in heart cells — most commonly in the SCN5A gene — and produces a characteristic pattern on an ECG. People with Brugada Syndrome are at risk of dangerous ventricular arrhythmias (abnormal heart rhythms), which can cause sudden cardiac arrest, most often at rest or during sleep.

Brugada Syndrome is more common in men and in people of South-East Asian descent. It may be diagnosed after an unexplained cardiac arrest, after an abnormal ECG is found incidentally, or through family screening following a diagnosis in a relative.

The main treatment for those considered at high risk is an ICD (implantable cardioverter defibrillator), which can detect and terminate life-threatening arrhythmias. Certain medications and substances — including some antidepressants, sodium channel-blocking drugs, and large amounts of alcohol — can trigger arrhythmias in Brugada Syndrome and should be discussed with your cardiologist.

Because Brugada Syndrome is inherited, first-degree relatives (parents, siblings, and children) of anyone diagnosed should be offered cardiac screening.

Category: Implantable Devices

Even though most electromagnetic fields in the home environment will rarely affect the function of a pacemaker or ICD, it is recommended you keep any item containing magnets at least 15cm (6 inches) away from your device.

The reason for this is that there is a small magnetically activated switch built into pacemakers and ICDs. This internal switch is designed to close when a magnet of sufficient strength is placed over it.

When the switch closes in a pacemaker, the device paces the heart at a fixed pre-set rate (which may differ from your programmed settings).

When the switch closes in an ICD, it prevents the device from delivering treatment therapies.

You may not always know whether an item contains a magnet. However, if household items are used as intended and properly maintained, they should have no effect on your heart device. This includes microwaves, kitchen appliances, cordless phones, radios, televisions, computers, hair dryers, electric shavers, electric toothbrushes, electric blankets, and small power tools.

If you accidentally place a magnet too close to your device, simply move the item away. The pacemaker or ICD will return to its normal programmed settings once the magnet is removed.

The use of magnetic mattress pads and pillows is not recommended as it would be difficult to maintain a 15cm (6 inch) separation from your device at all times.

Category: Electromagnetic interference

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 cardiologist or device nurse. Your doctor will then determine the cause of the shock and may also make adjustments in the programming of your heart device.

Category: Living With an ICD

For most people, the practical impact of an ICD on daily life is less significant than they expect going into implantation. The device works continuously in the background and does not require any action from you under normal circumstances.

Most activities are possible with an ICD, including work, driving (after any mandatory restriction period), travel, sport, and sexual activity. The restrictions that apply depend far more on your underlying cardiac condition than on the device itself. Your cardiologist will give you specific guidance based on your individual diagnosis and risk profile.

There are practical adjustments to get used to. You will carry a device ID card at all times. You will attend regular clinic appointments, typically every six to twelve months, and may have a remote monitoring base station at home. Some electromagnetic sources require a safe distance. The device may occasionally produce sounds or alerts that need to be reported to your clinic.

The psychological adjustment is often the more significant challenge, particularly in the first year. Anxiety about a possible shock, changes to body image, and the constant reminder of cardiac risk are all common experiences. These are worth discussing with your cardiac team, and peer support from others living with an ICD can make a real difference. SCA UK can connect you with people who have been through the same process.

Category: Implantable Devices

Patients who meet the criteria for an ICD are at higher risk of sudden cardiac arrest (SCA). An ICD is implanted to help protect against this risk. Without an ICD, a life-threatening arrhythmia such as ventricular fibrillation may not be treated in time for the person to survive. You should discuss the risks of not having an ICD with your cardiologist or electrophysiologist, who can explain the benefits in the context of your specific condition.

Category: Implantable Devices

Yes. A hearing aid worn in the ear will not interfere with an ICD. If the hearing aid has any wireless accessories, such as a Bluetooth streamer worn around the neck, keep the accessory at least 15cm (6 inches) away from your device.

Category: Implantable Devices

The effect of turning off a lead depends on which lead it is and what function it was providing. ICDs can have between one and three leads, each connected to a different chamber of the heart or serving a different purpose.

A lead may be turned off because it is no longer functioning correctly, because it is causing inappropriate sensing or therapy, or because a new lead has been added to replace its function. In some cases a lead is left in place but deactivated rather than removed, as lead extraction carries its own risks.

Whether the device can still deliver full therapy after a lead is turned off depends on the configuration. If the defibrillation lead is unaffected, the device can still deliver a shock when needed. If a pacing lead is turned off, the device may pace less effectively or not at all in certain situations. Your cardiologist will explain exactly what the change means for your individual device programming and what, if any, additional monitoring or precautions are needed.

If a lead has been turned off and you are unsure what that means for your protection, ask your ICD clinic directly. You are entitled to a clear explanation of how your device is currently configured and what it will and will not do.

Category: Implantable Devices

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).

Category: Implantable Devices

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.

Category: Shock

ICD leads are thin, flexible wires that carry electrical signals between the device and the heart. During the implant procedure, the surgeon threads one end of each lead through a vein (usually the subclavian vein, near the collarbone) and guides it into the appropriate chamber of the heart. The tip of the lead is then anchored to the heart wall, either by a small corkscrew-like helix that screws into the tissue, or by tiny tines that grip the tissue passively.

The other end of each lead is connected to the ICD generator, which sits in a small pocket created under the skin near the collarbone. Most ICDs have one, two, or three leads depending on the type of device and what it needs to do.

Over the weeks after implant, tissue grows around the lead tip and anchors it more firmly. This is why activity restrictions in the first few weeks are important: moving the arm on the implant side too vigorously before the leads have settled can dislodge them. Your device clinic will tell you specifically what to avoid and for how long.

You can read more about the implant process and what to expect on our ICD information pages.

Category: Implantable Devices

Most ICDs today have both pacing therapies as well as defibrillation capabilities, so only one device is needed.

Category: Implantable Devices

Yes. Many people with ICDs and pacemakers choose to wear a medical ID bracelet or necklace alongside their device ID card. A medical ID can alert emergency responders to your device if you are unable to communicate. You can search online for suppliers of medical ID jewellery — several companies specialise in engraved medical alert products. Your local pharmacy may also stock basic options.

Category: Implantable Devices

ICD lead recalls and safety alerts do occasionally occur. In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for issuing medical device safety alerts, and manufacturers are required to notify affected patients and clinicians when a recall or field safety corrective action is issued.

If your leads are subject to a recall or safety alert, your ICD clinic should contact you directly with information about what has been found, what the risk level is, and what action if any is recommended. In many cases no immediate action is needed and increased monitoring is sufficient. In others, earlier replacement may be recommended. The decision is made on an individual basis taking into account the specific issue, your overall risk profile, and the risks of any procedure to address it.

If you have concerns about your leads and have not heard from your clinic, you can contact them directly and ask. You can also search the MHRA’s medical device alerts database at gov.uk/drug-device-alerts to see if any alerts have been issued for your device or lead model. You will find your device and lead model details on your device ID card or in your implant documentation.

Category: Implantable Devices

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.

Category: Implantable Devices

Your ICD clinic or cardiac nurse should give you a written shock plan before you leave hospital after implantation. This sets out exactly what to do if your device delivers a therapy shock. If you have not received one, ask for it at your next clinic appointment.

In general, if you receive a single shock and feel well immediately afterwards, contact your ICD clinic the same day or the next working day so the episode can be reviewed by downloading your device data. If you receive two or more shocks in quick succession, feel unwell after a shock, or the shock does not resolve your symptoms, call 999 immediately.

If you are unsure what to do in any situation, contact your ICD clinic. Most clinics have a dedicated number for urgent queries during working hours, and you should be given a number to call out of hours.

Category: Implantable Devices

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.

Category: Implantable Devices

ICDs are highly effective. When the device detects a dangerous heart rhythm, it delivers a shock in the vast majority of cases. Clinical evidence consistently shows appropriate shock delivery rates above 95%, though the exact figure varies depending on the device, the condition being treated, and how the device is programmed.

ICDs do not fail often, but they are not infallible. Lead fractures, sensing errors, and inappropriate shocks (where the device fires when it does not need to) are all recognised but relatively uncommon complications. Your device clinic monitors for signs of these at every check-up, and remote monitoring can flag concerns between appointments.

If your ICD delivers a shock, contact your device clinic or go to A&E. Whether the shock was appropriate or not, it should always be reviewed. Our page on living with an ICD covers what to do if your device activates.

Category: Implantable Devices

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.

Category: Implantable Devices

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.

Category: Implantable Devices

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.

Category: Implantable Devices

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.

Category: Implantable Devices

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.

Category: Implantable Devices

No, your ICD will only shock you if it detects a heart rhythm that is too fast.

Category: Shock

No, your ICD is designed to deliver a shock to treat heart rhythms that are too fast.

Category: Implantable Devices

This depends on your specific situation and DVLA regulations, and you must not assume it is automatically permitted. After a cardiac arrest or ICD implant, there is typically a mandatory period during which you are not allowed to drive any motor vehicle, including a motorcycle. For motorcycles specifically, the risk is heightened because an ICD shock or loss of consciousness while riding could cause a serious accident.

DVLA rules on riding after an ICD implant or cardiac arrest are complex and depend on the type of arrest, the rhythm involved, your licence group, and whether your ICD was fitted prophylactically or following an event. You must notify the DVLA of your ICD and wait for confirmation before riding again. Do not ride until your cardiologist and the DVLA have both confirmed it is safe to do so.

Our page on driving and the DVLA after cardiac arrest covers the regulations in more detail. If your situation is not clear after reading this, raise it directly with your cardiologist or device nurse.

Category: Implantable Devices

Yes. In the UK you are legally required to inform the DVLA if you have a condition or device that may affect your ability to drive safely. Having an ICD is a notifiable condition.

For Group 1 licences (car and motorcycle), there is typically a period of driving restriction following ICD implantation (usually six months), and further restrictions may apply if your device delivers a shock. For Group 2 licences (lorries and buses), the restrictions are stricter and in many cases permanent.

You should notify the DVLA using the appropriate medical questionnaire. For most people with an ICD, this is the DEFIB1 form, available on GOV.UK. If you drive a coach, bus or lorry (Group 2 licence), use the VOCH1 form instead. Your cardiologist or device clinic can support you with this process and provide any necessary medical information. You should also inform your motor insurer, as failing to disclose a relevant medical condition can invalidate your policy.

Always check the current DVLA guidance, as the rules are updated periodically. The full guidance is available at www.gov.uk/dvla/medicalenquiries.

Category: Implantable Devices

Always carry your heart device ID card. This card is helpful if your heart device sets off a metal detector or a security system.

Category: Implantable Devices

In the UK, driving after receiving an ICD is governed by DVLA regulations, not solely by your doctor’s assessment.

For Group 1 licences (car and motorcycle), a driving ban of at least six months typically applies following ICD implantation. If your ICD delivers a shock that causes or could have caused incapacity, a further period of restriction applies. Once the restriction period has passed and your cardiologist confirms your condition is stable, you can usually resume driving.

For Group 2 licences (lorries and buses), the restrictions are much stricter. Having an ICD typically results in permanent revocation of a Group 2 licence in most circumstances. This can have significant implications for professional drivers.

You are legally required to notify the DVLA and your motor insurer. Your cardiologist or device clinic will advise you on when it is medically appropriate to resume driving, but the final determination is made by the DVLA. Always check the most current guidance at www.gov.uk/dvla/medicalenquiries.

Category: Driving

If you go into cardiac arrest and an AED or external defibrillator is available, it should always be used. Do not hesitate because of your ICD. Saving your life takes priority.

An external shock can occasionally alter your ICD’s programmed settings or, in rare cases, cause minor damage to the device. For this reason, your ICD should be checked by your device clinic as soon as possible after any external defibrillation, even if you feel well. The clinic will test the device and confirm it is functioning and correctly programmed.

If you carry an ICD identification card, it can help emergency responders understand your situation, though it should never delay the delivery of a shock if one is needed.

Category: Implantable Devices

Your doctor will know if you recieve a shock as the ICD records and stores data when therapy like a shock is delivered.

Category: Implantable Devices

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.

Category: Shock