ICDs have become standard treatment for anyone who has survived cardiac arrest, and they're increasingly used in people at high risk of sudden cardiac arrest. An ICD lowers your risk of sudden death from cardiac arrest more than medication alone.
Although the electrical shocks can be unsettling, they're a sign that the ICD is effectively treating your heart rhythm problem and protecting you from sudden death. Talk to your doctor about how to best care for your ICD.
After the procedure, you'll need to take some precautions to avoid injuries and make sure your ICD works properly.
You'll likely be able to return to normal activities soon after you recover from surgery. Follow your doctor's instructions. For four weeks after surgery, your doctor might ask you to refrain from:
- Vigorous above-the-shoulder activities or exercises, including golf, tennis, swimming, bicycling, bowling or vacuuming
- Lifting anything heavy
- Strenuous exercise programs
Your doctor will probably advise you to avoid contact sports indefinitely. Heavy contact may damage your device or dislodge the wires.
Problems with your ICD due to electrical interference are rare. Still, take precautions with the following:
- Cellular phones and other mobile devices. It's safe to talk on a cellphone, but avoid placing your cellphone within 6 inches (about 15 centimeters) of your ICD implantation site when the phone is turned on. Although unlikely, your ICD could mistake a cellphone's signal for a heartbeat and slow your heartbeat, causing symptoms such as sudden fatigue.
Security systems. After surgery, you'll receive a card that says you have an ICD. Show your card to airport personnel because the ICD may set off airport security alarms.
Also, hand-held metal detectors often contain a magnet that can interfere with your ICD. Limit scanning with a hand-held detector to less than 30 seconds over the site of your ICD or make a request for a manual search.
- Medical equipment. Let doctors, medical technicians and dentists you see know you have an ICD. Some procedures, such as magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and radiofrequency or microwave ablation are not recommended if you have an ICD.
- Power generators. Stand at least 2 feet (0.6 meters) from welding equipment, high-voltage transformers or motor-generator systems. If you work around such equipment, your doctor can arrange a test in your workplace to see if the equipment affects your ICD.
- Headphones. Headphones may contain a magnetic substance that can interfere with your ICD. Keep your headphones at least 6 inches (about 15 centimeters) from your ICD.
- Magnets. These might affect your ICD, so it's a good idea to keep magnets at least 6 inches (15 centimeters) from your ICD site.
Devices that pose little or no risk to your ICD include microwave ovens, televisions and remote controls, AM/FM radios, toasters, electric blankets, electric shavers and electric drills, computers, scanners, printers, and GPS devices.
If you have an ICD to treat ventricular arrhythmia, driving a vehicle presents a challenge. The combination of arrhythmia and shocks from your ICD can cause fainting, which would be dangerous while you're driving.
The American Heart Association's guidelines discourage driving during the first six months after your procedure if your ICD was implanted due to a previous cardiac arrest or ventricular arrhythmia.
If you have no shocks during this period, you'll likely be able to drive again. But if you then have a shock, with or without fainting, tell your doctor and follow his or her recommendations. In most cases, you'll be discouraged from driving until you've been shock-free for another six months.
If you have an ICD but have no history of life-threatening arrhythmias, you can usually resume driving within a week after your procedure if you've had no shocks. Discuss your situation with your doctor.
You usually can't get a commercial driver's license if you have an ICD.
The lithium battery in your ICD can last up to seven years. The battery will be checked during regular checkups, which should occur about every six months. When the battery is nearly out of power, your old shock generator is replaced with a new one during a minor outpatient procedure.
ICDs and end-of-life issues
If you have an ICD and become terminally ill, your ICD will still deliver shocks if it isn't deactivated. Turning off your ICD is an easy procedure, and doing so won't immediately cause your heart to stop. But turning off the device can prevent unwanted shocks and unnecessary suffering.
Talk to your doctor about your wishes. Also talk to family members or another person designated to make medical decisions for you about what you'd like to do in end-of-life care situations.