ICDs control arrhythmias and reduce the risks associated with this, so that you can carry on your life and normal activities.

However, it will not ‘cure’ your cardiomyopathy, and you will still have your underlying condition. The following information is about having an ICD, but there may be issues around your cardiomyopathy that are also important to consider. For example, your ICD may not affect your ability to exercise, but this may be depend on your cardiomyopathy. 

You might like to talk to your cardiologist, nurse or device clinic if you have concerns about any activities.

Is it safe to be around magnets and electrical equipment?

ICDs are electromagnetic devices and have built-in protection (like a ‘shield’) that gives protection from magnets and electromagnetic fields. However, they can be affected by strong magnets and  electromagnetic fields (produced by electrical equipment and wireless devices), or those too-close to your device. Magnets can activate a switch in some devices that stops it from working (although it should turn back on when the magnet is removed). Electromagnetic fields can cause damage to or deactivate ICDs, or cause them to give a shock. 

It is worth knowing that most day-to-day electrical appliances are safe to be used by people with ICDs.

• Wireless devices (such as digital music players, e-readers, and headphones) should not cause any problems.
• Mobile phones can be safely used.
• Computers, laptops and tablets are considered safe. However, when use or carry a laptop or tablet do not hold it close to your chest. Photocopiers and printers are also considered safe.
• You may be able to use a TENS machine (for pain control), depending on where on the body you use it and how close this is to your device.
• Household items such as TVs, remote controls, microwaves, chargers and irons are usually safe.

 However, there are some guidelines which are helpful to know.

• Avoid strong magnets or electromagnetic fields. If your work involves using technology or machines with electromagnetic fields, talk to your employer and doctors about whether this may be a problem for you.
• Avoid using any faulty or poorly-wired equipment that may cause an electric shock.
• If you go to a shop with a metal detector at the door, don’t stand or linger in the area around the detector. Also, be aware that your ICD could set off a metal detector (and so having your ICD identification card can be helpful).
• Keep items such as electric shavers and toothbrushes, hairdryers, speakers and radio-controlled items at least 15cm from your device.
• Keep at least 60cm away from induction hobs.
• If you are due to have any dental or medical tests or procedures it is important that your healthcare professional is aware that you have an ICD so that they can take any necessary precautions. Some
  medical equipment could affect your device.
• It is a good idea to consult a gym instructor before using electrical gym equipment, or contact the manufacturer of the equipment for further information.

You can find more guidance in the patient booklet from your device company. You can also ask your device clinic for any specific guidance.

If your device is affected by an electromagnetic source, you may feel dizzy or light-headed, or experience arrhythmias. It is possible that your device may fire. If you move away from the source, or let go of what you are holding (if it is a hand-held device), your device should return to normal. If you are concerned about your device working, or you have had prolonged contact with an electromagnetic source, you may want to contact your doctor or device clinic.

Can I have an MRI?

MRIs use strong magnetic fields to build up a picture of the body, and involve being inside a strong magnetic field. For this reason, for some devices you will not be able to have an MRI. This is for devices that are not ‘MRI compatible’ because the MRI could damage or affect the settings of your device. However, some devices are ‘MRI-compatible’ and so are considered safe in an MRI, under certain conditions. 

Your ICD card should say whether your device is compatible with an MRI or not. If you are likely to need an MRI it is important that your doctor knows that you have an ICD.

What about travelling and airports?

If you have an implanted device you may have concerns about security checks at airports that include scanners which check for any hidden prohibited items. Although the Medicines and Healthcare products Regulatory Agency (the organisation that regulates the safety of medicines and medical devices in the UK) consider that you can safely use airport security scanners, the following may be helpful.

• Let the staff know that you have a device as soon as you approach the security desks, and show them your ICD identification card.
• If the scanner is a walk-through one (an archway scanner), walk at a normal pace and do not pause or stop in the scanner.
• If the scanner is an electronic wand (that is passed over your body) ask the staff to avoid passing it close, or repeatedly, over your heart.
• If the scanner is a full-body one (where you have to stop inside it to be scanned) these use ‘millimetre wave’ technology, and are considered safe for people with medical implants.
• If you are concerned, you could ask to be searched by hand instead. 

If you are concerned, contact your follow-up clinic before you travel.

Read our information about ‘Travel and cardiomyopathy’.

Can I exercise or do sports with an ICD?

Some people worry that a change in their heart rate, due to exercise, could cause their ICD to give them a shock. Generally, people with an ICD can exercise, and an ICD is no more likely to give a shock during exercise than at any other time. The arrhythmias detected by an ICD that trigger a shock are usually faster (higher heart rate) than what happens during normal exercise.

An exercise test can help to programme an ICD to recognise the person’s normal heart rate, even when exercising, and only gives a shock at the appropriate time (for heart rates above your normal exercising
heart rate). For some people, regular exercise might help to reduce the risk of arrhythmias. It is also a good idea to warm up before, and to cool down after exercise, so that your heart rate increases and
decreases gradually, and to reduce the risk of arrhythmias. 

Once you have recovered from having an ICD implanted, your ICD should not limit your physical movement. However, over-stretching your arm and shoulder could affect the leads, and this could affect what exercise is suitable for you. Also, pressure on the ICD itself should be avoided, and this could also affect what exercise and activities you do, and you may need to avoid contact sports or high
impact sports.

However, it is important to consider your underlying cardiomyopathy and whether this may have an impact on your physical activity. 

It is a good idea to talk to your doctor or device clinic about what exercise will be suitable for you.

Read our information on ‘Cardiomyopathy and exercise’.

Can I drive with an ICD?

There are driving standards related to having a device implanted or a battery replaced, and what to do following a shock from an ICD, these mean that you will have to stop driving for a period of time and may need to inform the DVLA. How this applies to you will depend on the type of device you have, and your driving licence (car or vocational licence). There are also driving standards for specific types of
cardiomyopathy, and for specific symptoms, depending on your situation. However, once you meet the standards for driving you should be able to drive again.

Read our information on ‘Cardiomyopathy and driving’.

Is it safe to have sex when you have an ICD?

It is not unusual for people to be concerned about sex and whether it might trigger an ICD to fire if your heart rate increases. The increase in heart rate during sex usually happens gradually, and is still under the rate at which an ICD would normally fire. Your ICD will be programmed so that it will not fire at your normal heart rate or the rate during exercise or general physical activity. So once you have
recovered from having the ICD implanted and your wounds have healed, you can normally have sex without any concerns. However, it is best to avoid positions that put pressure directly on the ICD itself.

Will having an ICD affect what I can wear?

A regular ICD usually sits underneath the collarbone, although an S-ICD sits lower down the body (see page 16-17). The placement of the device may vary slightly depending on your build and the type of
ICD you are having implanted. However, this can mean that the device sits where your clothes, for example, a bra strap or straps on a rucksack, also sit. For some this might be uncomfortable, and using
straps with padding might help this. You can talk to your surgeon before implantation to see where your device will sit, and how it might affect you, and discuss any concerns you have. 

©Cardiomyopathy UK. April 2018