How do you get the best results from a pacemaker?

When you have a pacemaker, it's important to avoid strong magnetic and electrical fields. The lists below give some safety guidelines for pacemakers and ICDs. They show some electrical and magnetic sources and how they may affect your pacemaker. For best results, follow these guidelines. These safety tips also apply to devices that combine an ICD and a pacemaker. If you have questions, check with your doctor.

Your doctor or the manufacturer of your pacemaker can give you a full list of things that you need to avoid and things that are safe to use.

Stay away from

• CB or ham radios
• High-voltage power lines. Stay at least25 ft (7.5 m)away.
• Large magnets
• MRI machines, unless you have a device that is safe in an MRI machine. An MRI uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body.

Use with caution

• Cell phones:
  • Do not carry a cell phone in a pocket directly over the pacemaker or ICD.
  • Hold the phone to the ear on the side away from your device.
  • Keep a phone at least 6 in. (15 cm) away from the pacemaker or ICD.
• MP3 player headphones:
  • Do not keep headphones in a chest pocket.
  • Do not drape headphones over your chest.
• Security or anti-theft detectors (metal detectors):
  • Walk through the detector at a normal pace.
  • Don't stand near or lean against the gates or archway.
• Keep the following devices at least12 in. (30.5 cm) away from the pacemaker or ICD:
  • Arc welders
  • Battery-powered cordless power tools
  • Industrial power generators
  • Magnets
  • Magnetic wands used at airports
  • Stereo speakers
  • Radio transmitters (including those used in toys)

Safe to use

• Kitchen and bathroom equipment:
  • Bathroom appliances (electric razors, curling irons, and hair dryers)
  • Kitchen appliances (such as toasters, blenders, electric can openers, and refrigerators)
  • Microwave, gas, and electric ovens
• Other household items:
  • Electric tools (such as drills and table saws)
  • Lawn and garden equipment (such as mowers and leaf blowers)
  • Heating pads and electric blankets
  • Washing machines and dryers
  • Phones (land-line phones including cordless models)
  • Remote controls
  • TVs, VCRs, CD players, DVD players
• Office equipment:
  • Computers
  • Copy machines
  • Fax machines
  • Printers

Call your doctor if an alarm goes off

Some pacemakers have an alarm system that can tell you when to call your doctor. The alarm does not mean that your pacemaker is not working. It means that your doctor needs to check something on your pacemaker. 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.

Call your doctor right away if you hear or feel an alarm.

Having medical tests and procedures

Most medical tests and procedures won't affect your pacemaker, except for MRI, which uses strong magnets. To be safe:

• Let your doctors, dentists, and other health professionals know that you have a pacemaker 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.

Traveling

You can travel safely with a cardiac device. 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.

Driving

You can drive if you have a pacemaker and you don't have any symptoms such as fainting. But right after you get a pacemaker, your doctor will likely ask you to not drive for at least a week after the device is implanted. This gives you time to heal.

Letting others know

• Carry a pacemaker identification card 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 a pacemaker. You can buy this at most drugstores or online.

Having follow-up

• Go to all your appointments with your doctor to check your pacemaker . In between checkups, you will probably send information from your pacemaker to your doctor through a phone line or the Internet. You might do this manually or your device might do it automatically.
• If you take heart rhythm medicines, take them as prescribed. The medicines work with your pacemaker to help your heart keep a steady rhythm.
• Your doctor and/or the device maker will contact you about what to do if your device is recalled .

Exercising safely

Pacemakers often are used to improve your ability to exercise. Most people with pacemakers have active lives and can exercise . Talk to your doctor about the type and amount of exercise and other activity you can do.

In general:

• You may need to limit your activity if you have an irregular heart rate caused by heart failure or another heart problem.
• Talk with your doctor about what type and level of exercise is safe for you. You may choose to avoid contact sports, such as soccer or basketball, because the device can be damaged. Sports such as swimming, running, walking, tennis, golf, and bicycling are safer.
• If you want to do strength-training exercises, ask your doctor or a fitness trainer to suggest ones that are safe for someone who has a pacemaker. Some exercises might put too much strain on your device.

Having sex

Most people who have a pacemaker can have an active sex life . After you get a pacemaker implanted, you'll let your chest heal for a short time. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.

Talk with your doctor if you have any concerns.

Planning for the future

As you plan for your future and your end of life, you can include plans for your pacemaker. You can make the decision to turn off your pacemaker as part of the medical treatment that you want at the end of life. You can put this information in your advance directive .

When to call a doctor

Call your doctor right away if you have symptoms that could mean your device isn't 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.

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

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