Living With a Pacemaker or Implantable Cardioverter Defibrillator (ICD)

Living with a pacemaker or ICD:

With advances in technology, pacemakers and ICDs generally last 5 to 6 years (depending upon usage and the type of device) and, in most cases, allow a person to lead a normal life. In addition, advances in device circuitry and insulation have reduced the interference risk from machinery, such as microwaves, which, in the past, may have altered or otherwise affected these surgically implanted cardiac devices. Even so, certain precautions must be taken into consideration when a person has a pacemaker or ICD.

What precautions should I take with my pacemaker?

The following precautions should always be considered. Discuss the following in detail with your physician:

  • Although it is generally safe to go through airport security detectors (they will not damage the pacemaker or ICD), inform airport security personnel that you have a pacemaker before you go through security, as the device may set off the alarm. Also, if you are selected for a more detailed search, politely remind security that the hand-held metal-detecting wand should NOT be held over the pacemaker for any prolonged period of time (more than a second or two), as the magnet inside the detecting wand may temporarily change the operating mode of a pacemaker. 
  • Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields, as these may affect the programming or function of the pacemaker. Also, the rapidly changing magnetic field within the MRI scanner can, in theory, cause heating of the pacemaker leads. In general, there are alternatives to MRI for persons with pacemakers, but if your doctor determines that you absolutely need an MRI scan, discuss this thoroughly with your cardiologist before proceeding. If he or she and you agree to go ahead, you should be closely monitored by a cardiologist, with a pacemaker programming device immediately available, during MRI scanning. 
  • Abstain from diathermy (the use of heat in physical therapy to treat muscles).
  • Turn off large motors, such as cars or boats, when working on them (they may temporarily "confuse" your device).
  • Avoid certain high-voltage or radar machinery, such as radio or television transmitters, arc welders, high-tension wires, radar installations, or smelting furnaces.
  • If you are having a surgical procedure performed by a surgeon or dentist, tell your surgeon or dentist that you have a pacemaker or ICD. Some surgical procedures will require that your ICD be temporarily turned off or set to a specific mode; however, this will be determined by your cardiologist. Temporarily changing the mode on your pacemaker can be performed noninvasively (no additional surgery is required), but should only be performed by qualified medical personnel. 
  • Always carry an ID card that states you have a pacemaker/ICD. It is recommended that you wear a medic alert bracelet or necklace if you have a device.
  • You may have to take antibiotic medication before any medically invasive procedure to prevent infections.

Always consult your physician or device company if you have any questions concerning the use of certain equipment near your pacemaker/ICD.

Can I participate in regular, daily activities with a pacemaker/ICD?

Once the device has been implanted, people with pacemakers/ICDs should be able to do the same activities everyone else in their age group is doing. When you have a pacemaker/ICD, you may still be able do the following:

  • exercise moderately, upon advice from your physician
  • drive your car or travel if cleared by your doctor
  • return to work
  • work in the yard or house
  • participate in sports and other recreational activities
  • take showers and baths
  • continue sexual relationships

When involved in a physical, recreational, or sporting activity, a person with a pacemaker/ICD should avoid receiving a blow to the area over the device. A blow to the chest near the pacemaker/ICD can affect its functioning. If you do receive a blow to that area, see your physician.

Always consult your physician when you feel ill after an activity, or when you have questions about beginning a new activity.

How can I ensure that my pacemaker is working properly?

Although your pacemaker is built to last several years, you should always have it checked  regularly to ensure that it is working properly. Different physicians may have different schedules for checking devices, and most are checked in the home using a telephone and special equipment provided by your device manufacturer.

Battery life, lead wire condition, and various functions are checked by performing a device interrogation. During an interrogation the device is noninvasively connected to a computer using a magnet and a special machine.

Your physician may ask you to check your pulse rate periodically. Report any unusual symptoms or symptoms similar to those you had prior to the device insertion to your physician immediately.

Always consult your physician for more information, if needed.

What is the pulse?

The pulse rate is a measurement of the heart rate, or the number of times the heart beats per minute. As the heart pushes blood through the arteries, the arteries expand and contract with the flow of the blood. Taking a pulse not only measures the heart rate, but also can indicate:

  • heart rhythm (abnormal rhythm may indicate a heart disorder)
  • strength of the pulse (a weak pulse may indicate a fast heart beat in which some beats are too weak to feel, heart failure, or a low volume of blood in the circulatory system)

The normal pulse rate for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men. Athletes, such as runners, who do a lot of cardiovascular conditioning may have heart rates in the 40s and experience no problems.

Illustration demonstrating how to take a pulse
Click Image to Enlarge

How to check your pulse:

As the heart forces blood through the arteries, you feel the beats by firmly pressing on the arteries, which are located close to the surface of the skin at certain points of the body. The pulse can be found on the side of the lower neck, on the inside of the elbow, or at the wrist. When taking your pulse:

  • Using the first and second fingertips, press firmly but gently on the arteries until you feel a pulse.
  • Begin counting the pulse when the clock's second hand is on the 12.
  • Count your pulse for 60 seconds (or for 15 seconds and then multiply by four to calculate beats per minute).
  • When counting, do not watch the clock continuously, but concentrate on the beats of the pulse.
  • If unsure about your results, ask another person to count for you.
  • It is probably better to check the wrist (radial artery) pulse than a neck (carotid artery)pulse. if you must check a neck pulse, do not press hard on the neck, and never press on both sides of the neck at the same time, as this can cause some people to pass out.


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