Having an ICD implanted can be seen as a rather big event in your life. However with help and support, most people adapt well over time. After a fairly short recovery period you should be able to return to previous activities however some restrictions will apply for your own safety.
The Roads and Traffic Authority (RTA) have strict guidelines in relation to patients who require an ICD and whether or not they are safe to drive. There are some restrictions but these vary depending on why you have had your ICD fitted. It is very important that you discuss this with your technician or doctor at your ICD centre who will explain this in more detail. You will also need to inform your insurance company that you have had an ICD fitted.
A certain level of exercise is needed to keep your heart healthy. It is natural to be concerned about the possibility of the ICD delivering a shock or stressing the heart. Following your initial recovery, normally about 4-6 weeks, it is recommended that you try to increase your level of activity if possible. You may be offered cardiac rehabilitation or exercise testing to restore your confidence. Once your wound has fully healed, you will be able to go swimming if you wish. However you are advised not to swim alone. Contact sports are not advised as the device or leads may become dislodged.
It is very common to be reluctant to resume sexual activity. However the device will not cause any harm to your partner, even if a shock is delivered to you during intercourse.
You can safely use equipment (such as electric drills) as long as they are in good working order, although you should keep them away from your ICD site.
This should be avoided.
Electromagnetic interference will not damage your ICD but may stop it from delivering any treatment for the period of time that you are in contact with it. Most electrical equipment that you come into contact with in day-to-day life, such as radios, fridges, cookers, computers and microwaves, will not affect your ICD as long as they are in good working order. However, should you ever feel dizzy or experience palpitations whilst using an electrical appliance, you should move away from the appliance and telephone the technician or doctor at the ICD clinic for advice. When buying electrical equipment / tools / appliances the instructions often say “do not use if you have a Pacemaker / ICD”. This is usually to protect the manufacturer from being sued and is not normally a problem. If you do come across any of these items talk to your ICD clinic who will be able to advise you.
Do not carry magnets or place a magnet over your chest! Avoid carrying stereo or hi-fi speakers as they contain strong magnets that can interfere with your ICD. ICD therapies may be temporarily disabled by magnets.
Shop doorway security systems
There is a very small risk of interference to your ICD, so you are advised to walk through shop doorways at a normal pace and not to wait around in this area.
Electronic ignition systems
Avoid leaning over the alternator in a car whilst the engine is running, otherwise it is generally safe to work as a mechanic.
Medical equipment / other hospital treatments
Most equipment used by your hospital or GP surgery will not cause any problems to your ICD. However it is advised that you let medical and dental staff know that you have an ICD as technical support may be required before some treatments. Please take your ID card with you whenever you go to hospital. It may also be useful to contact your implanting centre for advice before you go into hospital for any investigations or operations that are not associated with your ICD. It is safe for you to have X-rays, CT scans and mammograms. However you must not have magnetic resonance imaging (MRI) scans unless you are sure your ICD is MRI compatible. Some electrical nerve and muscle stimulators (TENS units) may cause interference with ICDs but this depends on where they are being applied. If this form of treatment is suggested to you then your ICD clinic should be contacted for advice.
If you require an operation, you must tell your surgeon and anaesthetist that you have an ICD implanted. It may be necessary to temporarily switch off (deactivate) the shocks on your ICD for the duration of the operation. This can be done through a programmer, but equally using a magnet taped over your ICD.
Deactivating ICD shocks
As well as being able to temporarily switch off your ICD shocks during operations, there may be certain circumstances which would cause you to consider having your ICD ‘deactivated’. For example, if you are diagnosed with a terminal illness, you may not wish to have the added burden of worrying if you will be shocked by your ICD when this will no longer provide life-saving treatment. This will only be carried out at your request and after you have been fully informed of your choices. Should circumstances change, the ICD can be easily switched back on.
You can safely travel abroad with your ICD, but you are advised to show security staff your identification card and ask to be searched by hand. This is because the hand held wands can temporarily interfere with your ICD. Walk through the metal detector archway if asked to do so, but the metal casing of the device may set off the airport security alarm. The detector will not cause any harm to your ICD provided you walk briskly through the arch. You will need to make sure that your travel insurance company is aware that you have an ICD.
Mobile phones / iPods / MP3 players
Some studies have shown that mobile phones and MP3 players can affect the ICD if held within six inches (15cm) of the device. It is therefore recommended that you do not keep them in a coat or shirt pocket over the ICD. Keep the handset more than six inches away from the ICD; ideally hold your phone over the ear on the opposite side to the device.