Living With a Pacemaker Key Points

A pacemaker or an implantable cardioverter-defibrillator (ICD) helps protect you against dangerous heart rhythms. It's important to know how these devices work and how to keep them working right. Learning a few important facts about pacemakers and ICDs can help you get the best results from your device.

Key points

• Avoid strong magnetic and electrical fields. These can keep your device from working right.
• Most office equipment and home appliances are safe to use. Learn which things you should use with caution and which you should stay away from.
• Be sure that any doctor, dentist, or other health professional you see knows that you have a pacemaker or ICD.
• Always carry a card in your wallet that tells what kind of device you have. Wear medical alert jewelry that says you have a pacemaker or ICD.
• Have your pacemaker or ICD checked regularly to make sure it is working right.

Pacemakers and ICDs are small electrical devices that help control the timing of your heartbeat.

• A pacemaker is implanted under the skin of your chest wall. The pacemaker's wires are passed through a vein into the chambers of your heart. The pacemaker sends out mild electrical pulses that keep your heart from beating too slow.
• An implantable cardioverter-defibrillator (ICD) is implanted under the skin in your chest. A wire threaded through a large vein connects the device to your heart. An ICD is always checking your heart rate and rhythm. If the ICD detects a life-threatening rapid heart rhythm, it tries to slow the rhythm to get it back to normal. If the dangerous rhythm does not stop, the ICD sends an electric shock to the heart to restore a normal rhythm. The device then goes back to its watchful mode. If your heart is beating too slow, the ICD acts as a pacemaker, sending mild electrical pulses to bring your heart rate back up to normal. 

Pacemakers and ICDs run on batteries. To be sure that your device is working right, you will need to have it checked every few months. Your doctor will also make sure your pacemaker settings are right for what your body needs.
You may need to go to your doctor’s office, or you may be able to get the device checked over the phone or the Internet.
In most cases, ICD or pacemaker batteries last 5 to 15 years. When it is time to replace the battery, you will need another surgery, although it will be easier than the surgery you had to place the device. The surgery is easier, because your doctor does not have to replace the leads that go to your heart.

Works Consulted

• Akoum NW, et al. (2008). Pacemaker therapy. In EG Nabel, ed., ACP Medicine, section 1, chap. 7. Hamilton, ON: BC Decker.
• Baddour LM, et al. (2010). Update on cardiovascular implantable electronic device infections and their management. A scientific statement from the American Heart Association. Circulation, 121(3): 458–477.
• Lee S, et al. (2009). Clinically significant magnetic interference of implanted cardiac devices by portable headphones. Heart Rhythm, 6(10): 1432–1436.
• Sears SF, et al. (2005). How to respond to an implantable cardioverter-defibrillator shock. Circulation, 111(23): e380–e382.
• Swerdlow CD, et al. (2012). Pacemakers and implantable cardioverter-defibrillators. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 745–770. Philadelphia: Saunders.
• Wilkoff BL, et al. (2008). HRS/EHRA expert consensus on the monitoring of cardiovascular implantable electronic devices (CIEDS): Description of techniques, indications, personnel, frequency and ethical considerations. Heart Rhythm, 5(6): 907–925. Available online: http://www.hrsonline.org/Policy/ClinicalGuidelines/upload/cieds_guidelines.pdf.