Heart Conditions in Adults - Living With a Pacemaker or Implantable Cardioverter Defibrillator (ICD)

Living with a pacemaker or ICD:

With advances in technology, pacemakers and ICDs today generally last several years (depending upon usage and the type of device) and, in most cases, allow a person to lead a normal life. In addition, advances in device circuitry and insulation have reduced the interference risk from machinery, such as microwaves, which, in the past, may have altered or otherwise affected these surgically implanted cardiac devices. Even so, certain precautions must be taken into consideration when a person has a pacemaker or ICD.

What precautions should I take with my pacemaker?

The following precautions should always be considered. Discuss the following in detail with your physician:

• Use caution when going through airport security detectors. Check with your physician about the safety of going through such detectors with your particular device.
• Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields.
• Abstain from diathermy (the use of heat in physical therapy to treat muscles).
• Turn off large motors, such as cars or boats, when working on them (they may temporarily "confuse" your device).
• Avoid certain high-voltage or radar machinery, such as radio or television transmitters, electric arc welders, high-tension wires, radar installations, or smelting furnaces.
• If you are having a surgical procedure performed by a surgeon or dentist, tell your surgeon or dentist that you have a pacemaker or ICD, so that electrocautery will not be used to control bleeding (electrocautery can interfere with the pacemaker or ICD).
• Always carry an ID card that states you have a pacemaker/ICD. It is recommended that you wear a medic alert bracelet or necklace if you have a device.
• You may have to take antibiotic medication before any medically invasive procedure to prevent infections.

Always consult your physician if you have any questions concerning the use of certain equipment near your pacemaker/ICD.

Can I participate in regular, daily activities with a pacemaker/ICD?

Once the device has been implanted, people with pacemakers/ICDs should be able to do the same activities everyone else in their age group is doing. When you have a pacemaker/ICD, you may still be able do the following:

• exercise moderately, upon advice from your physician
• drive your car or travel if cleared by your doctor
• return to work
• work in the yard or house
• participate in sports and other recreational activities
• take showers and baths
• continue sexual relationships

When involved in a physical, recreational, or sporting activity, a person with a pacemaker/ICD should avoid receiving a blow to the skin over the device. A blow to the chest near the pacemaker/ICD can affect its functioning. If you do receive a blow to that area, see your physician.

Always consult your physician when you feel ill after an activity, or when you have questions about beginning a new activity.

How can I ensure that my pacemaker/ICD is working properly?

Although your pacemaker/ICD is built to last several years, you should always have it checked regularly to ensure that it is working properly. Different physicians may have different schedules for checking devices, and some can be checked in the home using a telephone and special equipment provided by your device manufacturer.

Battery life, lead wire condition, and various functions are checked by performing a device interrogation. During an interrogation the device is connected to a computer using a magnet and a special machine.

Your physician may ask you to check your pulse rate periodically. Report any unusual symptoms or symptoms similar to those you had prior to the device insertion to your physician immediately.

Always consult your physician for more information, if needed.

What is the pulse?

The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can indicate:

• heart rhythm (abnormal rhythm may indicate a heart disorder)
• strength of the pulse (a weak pulse may indicate a fast heart beat in which some beats are too weak to feel, heart failure, or a low volume of blood in the circulatory system)

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The normal pulse rate for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men. Athletes, such as runners, who do a lot of cardiovascular conditioning may have heart rates in the 40's and experience no problems.

How to check your pulse:

As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body. The pulse can be found on the side of the lower neck, on the inside of the elbow, or at the wrist. When taking your pulse:

• Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse.
• Begin counting the pulse when the clock's second hand is on the 12.
• Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to calculate beats per minute).
• When counting, do not watch the clock continuously, but concentrate on the beats of the pulse.
• If unsure about your results, ask another person to count for you.

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