Heart Disease Health Center

A pacemaker or an implantable cardioverter-defibrillator (ICD) helps protect you against dangerous heart rhythms. It's important to know how these devices work and how to keep them working right. Learning a few important facts about pacemakers and ICDs can help you get the best results from your device.

Key points

• Avoid strong magnetic and electrical fields. These can keep your device from working right.
• Most office equipment and home appliances are safe to use. Learn which things you should use with caution and which you should stay away from.
• Be sure that any doctor, dentist, or other health professional you see knows that you have a pacemaker or ICD.
• Always carry a card in your wallet that tells what kind of device you have. Wear medical alert jewelry that says you have a pacemaker or ICD.
• Have your pacemaker or ICD checked regularly to make sure it is working right.

Pacemakers and ICDs are small electrical devices that help control the timing of your heartbeat.

• A pacemaker is implanted under the skin of your chest wall. The pacemaker's wires are passed through a vein into the chambers of your heart. The pacemaker sends out mild electrical pulses that keep your heart from beating too slow.
• An implantable cardioverter-defibrillator (ICD) is implanted under your skin, usually below the left collarbone. A wire threaded through a large vein connects the device to your heart. An ICD is always checking your heart rate. If your heart starts beating dangerously fast, the ICD sends a strong electrical shock to your heart to return it to a normal rhythm. If your heart is beating too slow, the ICD acts as a pacemaker, sending mild electrical pulses to bring your heart rate back up to normal.

Pacemakers and ICDs run on batteries. To be sure that your device is working right, you will need to have it checked every few months. Your doctor will also make sure your pacemaker 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.

In most cases, ICD or pacemaker batteries last 5 to 15 years. When it is time to replace the battery, you will need another surgery, although it will be easier than the surgery you had to place the device.

When you have a pacemaker or 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 pacemaker or ICD. For best results, follow these guidelines. If you have questions, check with your doctor.

Medical tests and procedures

Most medical tests and procedures will not affect your pacemaker or ICD, except for MRI, which uses strong magnets. To be safe:

• Let your doctors, dentists, and other health professionals know that you have a pacemaker or ICD before you have any test, procedure, or surgery.
• Have your dentist talk to your doctor before you have any dental work or surgery.
• If you need physical therapy, have the therapist contact your doctor before using ultrasound, heat therapy, or electrical stimulation.

Travel

• You can safely walk through airport security or anti-theft gates at a normal pace. But do not stand near or lean against them. Before you pass through a metal detector, tell the security guards that you have a pacemaker or ICD, and show them your device identification card. Your pacemaker or ICD may set off a metal detector, but the security archways will not damage the device.
• If you must be searched, ask the security guard for a hand search. The handheld security wand contains a strong magnet and should not be used. But if the handheld wand must be used, it should not be held over your pacemaker or ICD for a long period of time. The security guard should keep the wand at least 12 in. (30.5 cm) away from your pacemaker or ICD.
• If your device sets off a security alarm, show your device ID card.

Letting others know

• Carry an ICD or pacemaker ID card with you at all times. The card should include manufacturer information and the model number. Your doctor can give you a pacemaker or ICD identification card.
• Wear medical alert jewelry stating that you have a pacemaker or ICD. You can buy this at most drugstores.

Follow-up care

• Go to all your appointments with your doctor to make sure your device is working right. Your doctor and/or the device maker will contact you about what to do if your device is recalled.
• Take all your medicines as prescribed. The medicines work with your pacemaker or ICD to help your heart keep a steady rhythm.

When to call a doctor

Call your doctor right away if you have symptoms that could mean your device is not working properly, such as:

• Your heartbeat is very fast or slow, skipping, or fluttering.
• You feel dizzy, lightheaded, or faint.
• You have shortness of breath that is new or getting worse.

After an ICD shock

Be sure you have a plan for what to do if you get a shock from your ICD. Talk to your doctor if you need to make a plan. 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:

• Call 911 or other emergency services immediately if you feel bad or have symptoms like chest pain.
• Call your doctor soon if you feel fine right way. Your doctor may want to talk about the shock and schedule a follow-up visit.

After a second shock within 24 hours:

• Call your doctor immediately, even if you feel fine right away.

Infection near the ICD

Call your doctor right away if you think you have an infection near your ICD. Signs of an infection include:

• Changes in the skin around your ICD, such as:
  • Swelling.
  • Warmth.
  • Redness.
  • Pain.
• Unexplained fever.

Now that you have read this information, you know more about living with a pacemaker or 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.