ICD: Living Well With It

How do you get the best results from an ICD?

Here are a few things you can do to make the most of your ICD and feel good about it.

• Learn about your ICD.
  • This can help reduce any anxiety you may feel.
  • Know how it works, what it does, and how it keeps you safe.
• Use certain electric devices with caution.
  • Some electric devices have a strong electromagnetic field. This field can keep your ICD from working right for a short time.
  • Check with your doctor about what you need to avoid and what you need to keep a short distance away from your ICD. Many household and office electronics do not affect your ICD.
• Keep your regular doctor appointments.

  Your doctor:

  • Sets both the rate at which a shock will occur and the level of shock needed to bring your heart back to a normal rate.
  • Checks to see whether the ICD has given you any shocks since your last visit. This helps your doctor know if your medicines need to be adjusted.
  • Checks the ICD battery.
  • Will contact you about what to do if your device is recalled. The device maker may also do this.
  • Will check your heart rhythm medicines. The medicines work with your ICD to help your heart keep a steady rhythm.

  If you think you have an infection near your device, call your doctor right away. Signs of an infection include:

  • Changes in the skin around your device, such as swelling, warmth, redness, and pain.
  • An unexplained fever.
• Drive and travel safely.

  After you get an ICD or after you get a shock from the ICD, your doctor will suggest that you don't drive for a short time.

  • This is to help keep you and others safe. There is a risk that you might get an ICD shock or faint while you are driving.
  • Your doctor will let you know when you can drive again.

  You can travel safely with an ICD. But you'll want to be prepared before you go.

  • Bring a list of the names and phone numbers of your doctors.
  • Bring your cardiac device identification card with you.
  • Know what to do when going through airport security.
• Talk to your other health professionals.

  Many medical tests and procedures won't affect your ICD. But some procedures include electromagnetic fields that could affect how your ICD works. To be safe:

  • Let your doctors, dentists, and other health professionals know that you have an 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.
  • If you need an MRI, check with your doctor first. An MRI can be done if you have an ICD that is safe for an MRI. If you have another type of ICD, the test might be done safely in certain cases, but you will need to talk with your doctor about the benefits and risks.
• Exercise safely.

  Ask your doctor what sort of activity and intensity is safe for you and when you should stop exercising and call for help.

• Talk with others who have an ICD.

  Ask them if they have been shocked and what it was like. Ask them how they cope with it. Talking with others can help you feel better.

• Carry an ICD identification card and other information with you at all times.
  • The card should include manufacturer information and the model number. Your doctor can give you an ID card.
  • Wear medical alert jewelry stating that you have an ICD. You can buy this at most drugstores.
  • Have a list of all the medicines you are taking and your doctor's name and phone number.

  This will help you get the best possible treatment if you get a shock and need help.

• Don't make changes in what you do.

  You may want to avoid an action because you think it may cause or has caused a shock. But a shock can occur at any time, and you can't prevent shocks by your actions alone. Don't stop doing things you enjoy to try to avoid a shock.

• Know that sex is okay.

  Most people who have an ICD can have an active sex life. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.

  After you get the device placed, you'll let your chest heal for a short time before having sex again. If you or your partner is worried about having sex, talk with your doctor about your concerns. Your doctor or another health professional can give you support and advice.

  Many people with ICDs worry that the ICD might shock them during sex. The risk of getting a shock during sex seems to be the same as during any other similar level of exercise. If you get a shock during sex, you follow your plan about when to call your doctor. If you get a shock, your partner will not be shocked or feel any pain.

• Make a shock action plan with your doctor.

  This plan tells you who and when to call if you get a shock and how to stay calm.

• Make plans for the future.

  In an advance directive, include plans for your ICD. You can make the decision to turn off your ICD as part of the medical treatment you want at the end of life.

Devices that can affect your ICD

Some electric devices have a strong electromagnetic field. This field can keep your ICD from working right for a short time. These devices are in your home, garage, workplace, and hospital.

Your ICD may have an alarm, like a beep, that tells you when you are too close to an electromagnetic field. If you hear this alarm, move away from the source of the electromagnetic field.

Your doctor or the manufacturer of your ICD can give you a full list of what you need to avoid and what you need to keep a short distance away from your ICD.

Here are some examples.

Devices to avoid

Avoid devices with strong electromagnetic fields, such as:

• MRI machines, unless you have a device that is safe in an MRI machine or your doctor says you can safely have an MRI done with your ICD.
• Certain welding equipment.
• Electronic body-fat scales.

Devices to be cautious around

Keep your ICD at least 2 ft (0.6 m) away from:

• Jumper cables.
• Table saws.

Keep your ICD at least 12 in. (30 cm) away from:

• Car battery chargers.
• Ignition systems of gasoline-powered engines or tools.
• Induction cooktop stoves.
• CB radios.

Keep your ICD at least 6 in. (15 cm) away from:

• Electronic devices that use wireless technology.
• Cell phones and smartphones.
• Tablets and e-readers.
• Headphones and earbuds.
• Wearable devices that use wireless technology, such as fitness trackers.
• Hair dryers.
• Battery-powered and electric shavers.
• Vacuum cleaner motors.
• Small magnets.

Do not stand near:

• Anti-theft detectors in stores.
• Security systems in airports.

Making an ICD shock plan

The idea of living with an ICD and getting shocked worries some people. This is normal. After all, you don't know when a shock might occur, and a shock could be a reminder that your heart is not as healthy as it could be. You may find it helpful to work with your doctor to have a plan for what to do if you get a shock.

In general, your plan depends on how you feel after you get a shock and how many times you get a shock.

• Ask your doctor when and who you need to call for help.
  • Ask what to do after one shock. This depends on whether you have symptoms like chest pain.
  • Ask what to do if you get a second shock within 24 hours.
  • Here is an example:
    • Call 911 or other emergency services right away if you feel bad or have symptoms like chest pain.
    • Call your doctor soon if you feel fine right away after the shock.
    • Call your doctor right away if you get a second shock in a 24-hour period.
• Decide what you will do if you feel you need to calm yourself after the shock.

  Breathing exercises are one thing you could try. For example:

  • Sit or lie in a comfortable position. Put one hand on your belly just below your ribs and the other hand on your chest.
  • Take a deep breath in through your nose, and let your belly push your hand out. Your chest should not move.
  • Breathe out through pursed lips as if you were whistling. Feel the hand on your belly go in, and use it to push all the air out.
  • Breathe in and out like this until you feel more relaxed.
• Ask your doctor what to do if your ICD alarm goes off.

  Some ICDs have an alarm system that can tell you when to call your doctor. The alarm does not mean that your ICD is not working. It means that your doctor needs to check something on your ICD. For example, an alarm might mean that the battery needs to be checked.

  Your doctor can tell you what your alarm will sound like or feel like. You might hear beeping. Or you might feel a vibration, like a cell phone vibration. Your doctor may want you to call right away if you hear or feel an alarm.