An implantable cardioverter defibrillator (ICD) may save your life one day. Think of it as a tiny paramedic that sits in your chest ready to shock your heart if a dangerous irregular heartbeat (arrhythmia) starts. It can bring your normal rhythm back and help prevent sudden cardiac arrest.
Getting an ICD is a major decision. You may have questions about it. Knowing what to expect can help ease your mind.
What is it?
An ICD is a small battery-powered device with electrical wires that run to your heart. It's usually put under the skin on your left side just under your collarbone. It watches for life-threatening arrhythmias that start in your heart's lower chambers called the ventricles. If it notices one, the wires carry electrical pulses to your heart. The ICD first tries to fix the problem with low-energy pulses. If that doesn't work, or if your heart is quivering (called fibrillation), it uses high-energy shocks to get it back into normal rhythm.
The ICD doesn't prevent arrhythmia -- it corrects it once it starts. Your doctor probably will give you medicine to treat the problem.
What does a shock feel like?
You might not notice a low-energy shock . Or it may feel like a flutter in your chest. The high-energy shock lasts just a second, but it can hurt. Some people say it feels like being hit with a baseball bat or being kicked by a horse. Most people feel it more in their back than their chest. If you feel a shock, sit or lie down because you may pass out.
Talk to your doctor about what to do if you get shocked. She may want you to call her office. If you get more than one shock in 24 hours, you should go to the emergency room.
Can anything hurt my ICD?
You need to be aware of your surroundings when you have an ICD. Stay away from heavy equipment that has strong magnetic or electric fields (for example antennas, arc welders, and industrial equipment). These can affect the ICD's electric signals and keep it from working the way it should. It's safe to be around wood-working tools and typical home appliances, including microwave ovens. At stores, quickly walk through sections with anti-theft detector systems. Don't linger around them.
Use your cell phone with care. Keep it at least 6 inches away from the ICD. Don't put it in a chest pocket over the device.
How do I know it's working?
You'll see your doctor several times a year. He'll check your ICD with a device called a programmer. He'll hold it over your ICD, and it will gather information that tells your doctor how well your ICD is working. It will also show how much power is left in the battery and if it has fired. The programmer can be used to change the settings of the ICD.
ICDs can be checked over the phone or through an internet connection, too.
Does my ICD last a lifetime?
The battery usually lasts 4 to 8 years. It wears out quicker if your device fires off lots of shocks. When it runs down, you'll get a new ICD. Your original wires probably won't need to be replaced.
Do all my doctors need to know I have one?
Yes, doctors, dentists, and other medical professionals also should know what kind you have. You may need to avoid some medical tests, like a magnetic resonance imaging (MRI) scan, which uses powerful magnets and radio waves. If you need surgery, the device should be disabled. It's a good idea to wear a medic alert bracelet that says you have an ICD.
Will I be able to work?
Probably. Most people can. It depends on what you do for a living. Talk to your doctor about your specific situation.
Can I drive?
Your doctor may want you to stop driving for as long as 6 months after you get the ICD or after you've been shocked. Talk to her about whether it's safe to get behind the wheel with your heart condition, especially if you occasionally get weak, dizzy, or faint.
You won't be able to drive professionally if you get an ICD.
Will it hurt my sex life?
The ICD shouldn't get in the way in the bedroom. Your heart rate typically goes up during sex, but it shouldn't trigger a shock. If you do get a jolt, it won't hurt your partner.
Should I still exercise?
An ICD usually doesn't keep you from exercising or playing most sports. But talk to your doctor about the kind of activities that are OK for you. You might not be able to play contact sports like football that could damage the ICD or shake loose the wires that lead to your heart.
Can I travel?
Yes, but take a few precautions, especially if you're flying:
- Tell the security screener that you have an ICD.You can get a TSA notification card so you don't have to explain yourself in front of other people.
- Don't walk through the metal detector.Ask to be screened with a millimeter wave scanner or a pat-down.
- Don't put your medication in checked bags.Pack it in a carry-on. This will make sure you can get to it during the flight if you need it. And it won't be lost if your checked bag doesn't make it where you're going.
How can I manage my emotions?
Many people with ICD's are anxious or depressed because they're afraid the device won't work right or that a shock will hurt. But some people go for years without getting a shock. And if you do get one, the ICD is doing its job and probably saved your life.
Relaxation techniques like deep breathing or cognitive-behavioral therapy may help even out your emotions.
Where can I get support?
Connecting with others with an ICD can help you adjust. You may get practical tips that can come only from people in your same shoes. There's an ICD Support Group online, and you also can look on Facebook for a closed group. If face-to-face support is more your style, ask your heart doctor about groups that meet in your area. Or call your local heart hospital.