Defibrillators Living With an ICD or WCD

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After having surgery to implant an ICD or getting a fitting for a WCD, you will need regular visits with your healthcare provider to check your health, the device, and any medicines you take. Talk with your provider about resuming physical activity, driving, and sexual activity.

You will get an ID card with information about your device to keep with you. It can be helpful in an emergency, to show airport security, or for medical personnel who need to know more about your device. If you move or get a new phone number, contact the manufacturer of your device to get a new ID card.

Your ICD or WCD collects information about the device and your heart. Your healthcare provider may give you a remote monitoring box, too. The data from the box may go to the device’s manufacturer, your provider, or both.

Be aware of the signs of complications that may occur.

Once you have a cardioverter-defibrillator, you will visit your doctor at least every 6 months. At the follow-up visits, your provider may take these steps:

• Prescribe or adjust your medicines to lower the number of irregular heartbeats you have. Fewer irregular beats will mean fewer high-energy shocks from your device.
• Interrogate (check) your device to make sure it’s working right. Over time, your ICD may stop working well because its wires get dislodged or broken, its battery fails, your heart disease progresses, or other devices have disrupted its electrical signaling.
• Review data from your remote monitoring box.
• Check the device’s battery. Batteries in ICDs last between 5 and 7years. When the batteries in your device run down, you will need surgery to replace them. You may also need to replace the leads (wires) or the device itself.
• Order heart tests, including an electrocardiogram (EKG), to check for changes in your heart’s electrical activity.
• Check your risk of heart failure.
• Assess the possible benefit of ablation procedures. If adjusting your device and medicines does not reduce your irregular heart rhythms, your provider may suggest a procedure called catheter ablation to stop excess electrical signals in your heart.

Your WCD can only keep you safe if you’re wearing it. Although shocks from WCDs can be painful and sometimes cause burns, it's important to continue wearing the device after addressing any burns or minor skin injuries. You should always have it on, except when you are taking a shower or bath.

Your healthcare provider will explain how to charge and change the batteries in your WCD.

Be sure to respond to any alerts warning of problems with the vest. You’ll need to replace the sensor pads if the WCD gives you a shock.

If you hear a warning sound from your WCD, get in a safe position in case it sends a shock to your heart. You may faint. Warn others to step back so they don’t get shocked.

After ICD surgery, talk to your healthcare provider about when you can return to normal activities such as exercise, driving, and sex.

Physical activity

Ask your healthcare provider how much and what types of physical activity are safe. Most people can take part in sports and exercise, including strenuous activities. You may need to avoid full-contact sports, such as football, that can damage your ICD or loosen the wires in your heart.

Your provider may order a stress test to check the settings on your device for the heart rate you achieve during activity. With the information from a stress test, you and your coach or fitness instructor can identify any limits on your activities.

Driving

The dangerous heart rhythms that lead to a shock from an ICD or WCD can cause you to faint and lose control of your vehicle. When you can start driving again after getting an ICD or WCD or after getting a shock depends on several factors.

Some laws may limit your ability to drive legally:

• Many states have laws requiring you to wait 6 months before driving again if you received an ICD or WCD because you had a cardiac arrest or a dangerous arrhythmia.
• If your ICD or WCD gives you a high-energy shock, you may need to wait 6 months before driving again.
• People who have an ICD or WCD are not legally allowed to operate commercial vehicles.

The judgment of your healthcare provider can also help determine limits on driving.

• If you are at high risk for dangerous arrhythmias and your provider gave you an ICD or WCD to prevent a first cardiac arrest, they may advise you to wait a week after surgery before driving.
• Your provider may suggest driving restrictions based on the activity recorded by your device.
• Some providers are not familiar with legal restrictions on driving after getting an ICD or after getting a shock, so you may need to seek out this information yourself.

Sexual activity

Talk with your healthcare provider about when it is safe to resume sexual activity after getting an ICD or a WCD. Some people worry that having sex may increase the risk of cardiac arrest or getting a shock from their device. For most people with a cardioverter-defibrillator device, sexual activity is not risky., Your device is programmed to manage normal increases in heartrate.

If your device is giving you unneeded or many shocks, your provider may suggest avoiding sexual activity until your condition is stable.

Sexual partners may be concerned about getting shocked by a person’s cardioverter-defibrillator during sexual activity. With implanted devices, usually the partner feels nothing or just a tingle. The feeling is not harmful.

A WCD will give a warning sound if it is about to give a shock. Anyone who is touching you should immediately move away to avoid getting shocked.

ICDs and WCDs can deliver electrical energy at different strengths to regulate or restore your heartbeat.

• Low-energy electrical charges from your device are not painful. You may not notice them, or you may feel fluttering in your chest.
• High-energy charges last less than a second, but they can be strong or painful. Before a shock, you may feel symptoms of arrhythmia. If you feel one or two strong shocks in a short time and the symptoms go away, contact your healthcare provider and set up an appointment that day or the next day. They will want to check your condition and the device.
• Inappropriate (unneeded) electrical charges may be sent to your heart even if your heart is working correctly. Inappropriate charges can cause you to faint or feel pain. You’re more likely to get inappropriate charges during the adjustment period after ICD surgery. A damaged wire or a very fast heart rate due to extreme physical activity can trigger unnecessary charges. These charges may occur if you forget to take your medicines. Sometimes no reason is found.

If you are worried that you are getting charges too often or charges that are not needed, talk to your healthcare provider about adjusting your device. Read about how ICDs work.

Talk with your healthcare provider about taking precautions like these after getting an ICD or WCD:

• Keep cell phones and headphones at least 6 inches away from your device. Any item that uses electricity or transmits wireless signals creates magnetic fields that may interfere with your ICD or WCD. If you have an ICD on the left side of your chest, hold your cell phone to your right ear. Do not carry your headphones or earbuds in a chest pocket.
• Though the risk of harm is low from metal detectors, such as those used for airport security, show your ID card and ask for alternative inspection if you feel the need.
• Tell your dentist and other healthcare providers that you have an ICD or WCD. You can show them the card with information about your device.
• Check with your healthcare provider and device manufacturer before medical procedures. Some procedures can stop ICDs from working. Precautions depend on the procedure and your device model. For example, magnetic resonance imaging (MRI) can interfere with some ICDs. People with newer models may be able to undergo MRI safely. MRIs can also be done safely with older ICDs, as long as precautions are put in place.
• Be careful around gas-powered or electric tools and vehicle engines. Keep your ICD or WCD a safe distance away from power tools, as many of them create magnetic fields. Avoid leaning over car engines.

It is possible for a wire in an ICD to fire at the wrong time or get infected. There could be a problem with the device itself, or your health may have changed. Learn the warning signs of complications and make an action plan.

When to call your healthcare provider

Call your provider if you have symptoms that concern you, particularly:

• Dizziness
• Fainting
• Feeling out of breath
• Fever
• Heart palpitations (feeling as if your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)

Also, always call your provider if your device gives you a shock.

Sometimes an ICD or WCD does not work properly and cannot be fixed with changes in programming. When you visit your healthcare provider, ask whether the manufacturer has announced any problems with your device. The manufacturer may recall the device. If this happens, you may have to replace it.

When to call 9-1-1

Go to a hospital emergency department if you experience either of the following problems:

• You feel several strong shocks from your device in a short time.
• You have symptoms of a heart attack or warning signs of cardiac arrest.

When to contact the FDA

Alert the U.S. Food and Drug Administration (FDA) if you have a problem with your ICD or WCD or with an AED. In the U.S., the FDA tracks safety and effectiveness of approved devices through the MedWatch program. Manufacturers, healthcare providers, and consumers can report serious problems with medical devices or drugs. To submit a report to MedWatch:

• Complete and submit the report online.
• Download the form or call 1-800-332-1088 to request a form. Return it to the address on the form or submit it by fax to 1-800-FDA-0178.

If you have questions about an AED, contact the manufacturer.

Learn about more ways to report a problem on this FDA consumer page.

If you have survived a cardiac arrest, you may worry about having another one. After surgery to implant an ICD or after a fitting for a WCD, adjusting to living with the device may cause anxiety and stress. When your device sends a strong shock, it may startle or distress you or cause pain.

If you experience anxiety or depression, tell your healthcare provider about your concerns. Some people may develop post-traumatic stress disorder (PTSD) after surviving cardiac arrest or getting shocks from their ICD or WCD.

If your heart condition worsens or if you develop another serious health problem, Palliative care or hospice care may improve your quality of life and help make your daily life more comfortable. This type of care focuses on managing your symptoms to help avoid unnecessary tests or treatments and providing support to you and your loved ones.

If you have a transvenous ICD or a CRT-D, your healthcare provider can turn off the device’s defibrillation or shock function without surgery while the pacing function continues. This adjustment may improve quality of life for some people whose health is declining and who are receiving many shocks. Subcutaneous ICDs do not have a pacing function, but you can consult your provider about turning off the device if your health is worsening to the point that your lifespan is limited.

People who have an ICD or SCD may want to include their wishes about device deactivation in their health care advance directives. Planning for the future is an important step in making sure you get the medical care you want, even if you are unable to speak for yourself and others are making decisions for you.