Dos and Don’ts: Life with an ICD

Learn how you ICD helps you

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Will my cell phone ruin my ICD? What about metal detectors at airports? Here Cleveland Clinic cardiologist Thomas J. Dresing, MD, addresses some of the common questions asked by patients with implantable cardioverter defibrillators (ICDs):

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How does my ICD help me?

Your ICD (a small device, about the size of a pager, placed below the collarbone) continuously monitors your heart’s rhythm. If your heart beats too quickly, the ICD issues a lifesaving jot 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 that may be related to slow heart rates.”

Having an ICD, are there any activities I should avoid?

In general, Dr. Dresing says, patients with ICDs should follow the advice of their cardiologist to promote a heart-healthy lifestyle. “The defibrillator itself is quite durable and is not typically damaged by things such as minor trauma to the chest over the top of the defibrillator.

However, the leads (or wires) that are connected to the heart are less resistant to things like fracture or trauma.” For this reason, you should avoid repetitive movements such as “pulldown” exercises at the gym, or things like using a saw or other repetitive movements with the arm above your head on the side of your defibrillator.

Will microwaves and other appliances affect my ICD?

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.

Can I go through airport security and other checkpoints?

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.

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Will my cell phone ruin my ICD?

Cell phones can be used without any problems, but follow these tips: 1) Hold your phone to your ear on the side of your body opposite your ICD, 2) Don’t carry your phone in the “on” position in a chest pocket over or within six inches of your ICD, 3) Keep at least six inches of space between your ICD and your phone while using.

Is it safe for me to drive?

Many physicians recommend no driving for six months after your ICD is implanted, or after a shock. Discuss this issue with your physician to keep you and those around you safe.

Answers to your questions
Many of you wrote in questions about ICDs and pacemakers.  We asked  Bruce Wilkoff, MD, Director of the Cardiac Pacing and Tachyarrhythmia Devices at Cleveland Clinic to help us answer your questions:

1. We fly radio controlled model aircraft using 2.4 GHz spread spectrum radio technology. The transmitter is typically held with both hands slightly above belt high. Flights last usually 10 minutes duration at a time. Are there any specific concern regarding ICD or pacemaker devices with regard to our RC equipment?  Bob A

There is no evidence that there is interference between 2.4 GHz technologies.  This should be safe.

2. Would you tell me which is the best tool to use that will not affect my ICD: electric or gas, grass string trimmer, handheld blower? Also will raking cause the leads a problem?  Joseph O

All of these activities are low risk. It is also risky not to be active, so, on average it is better to be moderately active.  Using any of these tools is fine.

3. I have my defibrillator installed on my right side. I shoot my shotgun on the right shoulder for duck and pheasant hunting. I don’t do alot of hunting but do you think the kick of the shotgun will affect my leads? I think not as I’m 66 and quite active with golf and racquet ball. Thank you.  Ed M

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Use of the shotgun from the shoulder with leads does increase the risk of lead failure and should be avoided.  Golf is not a significant risk.  Racquet ball, if very active could have some increased risk of lead failure, but usually would not make a big difference.

4. Told to avoid the hand detector directly over the ICD ,but close was Ok at the airport and the walk-through is Ok. Comment?  HM B

Walking through is OK but will detect the ICD or pacemaker often.  Then you should be hand checked, do not use the hand scanner.  If you go through the scanner it will not affect the function of the ICD.

5. How will I know if the battery is working ok? I also get a little jerking in my left side at times. Why?  Howard K

You need to have your ICD or pacemaker checked at least 4 times a year, either in person or remotely from your home.  As the battery develops some depletion the frequency should increase so that when the battery indicates wear enough to be replaced it is detected soon thereafter.  Even then, there are 2 – 3 months of little to no risk of changing the behavior of the ICD.  If there is jerking in your side that is likely related to stimulation of non-heart muscle such as the diaghragm or skeletal muscle.  You should get an in-person evaluation of the leads to see why the jerking is happening and perhaps your doctor will be able to program to avoid the jerking.

6. Why can’t a person drive after having a defib/pacemaker implanted?  Beverly W

People can drive after an ICD but may not be able to drive if they have had fainting spells, especially if they were associated with therapy from the ICD.  For the first week after the ICD is implanted we restrict patients from driving to make sure that the leads are stable.  It is rarely the defibrillator that prevents driving.  It is the underlying heart disease.

7. I was recently prescribed amorodin. Can I still get an ablation ?  What would I need to do?  Dennis H

Ablations are effective even if you have been placed on amiodarone, but it will depend on the type of heart rhythm that you are encountering.

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