Heart Problems: Living With an ICD
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An implantable cardioverter-defibrillator (ICD) helps protect you against dangerous heart rhythms. It's important to know how this device works and how to keep it working right. Learning a few important facts about ICDs can help you get the best results from your device.
You may have a device that combines an ICD with a pacemaker, which keeps your heart from beating too slowly. For more information on pacemakers, see Heart Problems: Living With a Pacemaker.
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An implantable cardioverter-defibrillator (ICD) is a small electrical device that can stop a possibly deadly heart rhythm (arrhythmia).
An ICD is implanted under the skin in your chest. A wire threaded through a large vein connects the device to your heart. It is always checking your heart rate and rhythm. If the ICD detects a life-threatening rapid heart rhythm, it tries to slow the rhythm to get it back to normal. If the dangerous rhythm doesn't stop, the ICD sends an electrical shock to the heart to restore a normal rhythm. The device then goes back to its watchful mode.
If your heart is beating too slowly, the ICD acts as a pacemaker, sending mild electrical pulses to bring your heart rate back up to normal.
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If your heart is beating too fast, an ICD sends a strong shock to your heart.
To be sure that your device is working right, you will need to have it checked regularly. ICDs can stop working because of loose or broken wires or other problems. Your doctor will also make sure your ICD settings are right for what your body needs.
You may need to go to your doctor's office, or you may be able to get the device checked over the phone or the Internet.
ICDs run on batteries. In most cases, ICD batteries last 5 to 15 years. When it's time to replace the battery, you'll need another surgery, although it will be easier than the surgery you had to place the device. The surgery is easier, because your doctor doesn't have to replace the leads that go to your heart.
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It's important to have your ICD checked regularly to make sure it is working right.
When you have an ICD, it's important to avoid strong magnetic and electrical fields. The lists below show electrical and magnetic sources and how they may affect your ICD. For best results, follow these guidelines. These safety tips also apply to devices that combine an ICD and a pacemaker. If you have questions, check with your doctor.
Following safety tips
What to do if you get a shock
If you get a shock from your ICD, follow the plan you set up with your doctor. In general, your plan depends on how you feel after you get a shock and how many times you get a shock.
After one shock:
After a second shock within 24 hours:
Having medical tests and procedures
Most medical tests and procedures won't affect your ICD, except for MRI, which uses strong magnets. To be safe:
You can travel safely with a cardiac device. But you'll want to be prepared before you go.
If you have an arrhythmia or an ICD that makes it dangerous for you to drive, your doctor might suggest that you stop driving, at least for a short time. You probably don't have to stop or limit driving if your arrhythmia doesn't cause bad symptoms. For more information, see Heart Rhythm Problems and Driving.
Letting others know
Going to follow-up visits
If you think you have an infection near your device, call your doctor right away. Signs of an infection include:
Ask your doctor what sort of activity and intensity is safe for you. ICDs are set to shock at a specific heart rate. So your target heart rate during exercise will probably be at least 10 to 15 beats below the ICD discharge heart rate.
You doctor can help you learn how to use a rating of perceived exertion (RPE) as a way to tell how hard you are exercising. This can help you keep your heart rate at a safe level during exercise.
Stop exercising and call your doctor if you have:
Most people who have an ICD (implantable cardioverter-defibrillator) can have an active sex life. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.
After you get the device implanted, you'll let your chest heal for a short time before resuming sex.
What if I get shocked? Many people with ICDs worry that their ICD might shock them during sex. The risk of getting a shock during sex seems to be the same as during any other similar level of exercise. If you get a shock during sex, you will follow your plan about when to call your doctor.
Will my partner get shocked? Some people worry that if they get shocked during sex, their partner might be hurt. But your partner will not be shocked or feel any pain if you get shocked.
Coping with worry about ICD shocks
You may feel nervous about living with an ICD, and you may worry about getting shocked.
It's common to be worried about living with an ICD. After all, you don't know when a shock might occur, and a shock could be a reminder that your heart is not as healthy as it could be. But if you take a few simple steps, you can feel better about having an ICD.
Planning for the future
As you plan for your future and your end of life, include plans for your ICD. You can make the decision to turn off your ICD as part of the medical treatment you want at the end of life. You can put this information in your advance directive.
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It's safe to use a cell phone, but don't keep it in a pocket directly over your ICD.
You can't exercise or do other activity when you have an ICD.
Now that you have read this information, you know more about living with an ICD.
If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to make notes on pages where you have questions.
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