Features March 2011 Issue

Understand the Realities of Life with an ICD

Expert advice about what activities should and shouldn’t be avoided can help keep you safe and healthy.

Implantable cardioverter defibrillators (ICDs) can improve the quality of life for many heart patients, but a number of misconceptions and questions surround the devices. Cardiologists are often asked questions like, "Will my cell phone ruin my ICD?" or "What about metal detectors at airports?" We asked Cleveland Clinic cardiologist Thomas J. Dresing, MD, what people should know about living with an ICD.

ICDs are small devices, about the size of a pager, that are placed below the collarbone and continuously monitor the heart’s rhythm. If the heart beats too quickly, the ICD issues a lifesaving jolt of electricity to restore the heart’s normal rhythm and prevent sudden cardiac death.

"An ICD, in and of itself, does not do anything to make your heart stronger or have any effect on your symptoms," Dr. Dresing says. "All modern defibrillators can also function as pacemakers. In cases where a pacemaker is necessary, the pacemaker portion of the defibrillator can help to improve symptoms which may be related to slow heart rates."

Living with an ICD

"In general, once the recipient of an ICD has healed from the surgery, they eventually tend to not notice the presence of the defibrillator on a day-to-day basis," adds Dr. Dresing. "Because it physically occupies space typically in the upper chest region, there are times that certain movements or positions are less comfortable due to the presence of the defibrillator. However, the ‘bee stings’ (small shocks created by the ICD) usually do not cause any harm to the defibrillator or to the recipient."

If one shock occurs and recovery is immediate, you may want to call the device clinic to make sure everything is ok. If more than one shock occurs without rapid recovery, call 911 right away.

Some common concerns regarding ICDs include:

Microwaves and other appliances:

Normal household appliances and wood-working tools can be used without causing any interference. ICD patients should avoid strong magnetic fields and large magnets, antennas, arc welders, and industrial equipment.

Airport and other security devices:

Walk normally through theft detector systems, but do not linger around them. At the airport, show security your ID and ask to be hand searched.

Cell phones:

Cell phones can be used without any problems, but the following tips are advised: 1) Hold the phone to the ear on the side of the body opposite of the implanted device; 2) Do not carry the phone in the ON position in a breast pocket over or within six inches of the ICD; and 3) Maintain a minimum of six inches between the ICD and the phone.

Driving:

Many physicians recommend no driving for six months after implantation of an ICD, or after a shock. Discuss this issue with your physician to maintain your safety as well as that of others.

"In general, the advice to patients with a defibrillator is to follow the advice of their cardiologist to continue to promote a heart-healthy lifestyle," says Dr. Dresing. "The defibrillator itself is quite durable and not typically damaged by things such as minor trauma to the chest over the top of the defibrillator. However, the leads or wires which are connected to the heart are less resistant to things like fracture or trauma. For this reason, it is usually recommended that patients avoid repetitive movements such as ‘pulldown’ exercises at the gym, or things like using a saw or other repetitive movements with the arm above the head on the side of the defibrillator."