FAQ

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.

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.

Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) 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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

It is unlikely that you will receive recalled leads. But check with the lead manufacturer or your doctor if you have concerns.

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.

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.

Talk to your doctor or nurse about a “shock plan”— – what you should do if your heart device delivers a therapy shock.

Your doctor or nurse should give you specific instructions about when to contact your doctor if you have received a therapy shock.

In general, follow these steps if you feel the symptoms of a rapid heart rhythm or if you receive 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.

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.

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.

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.

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

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

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

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.