Heart Problems: Living With a Pacemaker
A pacemaker keeps your heart from beating too slowly. It's important to know how this device works and how to keep it working right. Learning a few important facts about pacemakers can help you get the best results from your device.
You may have a device that combines a pacemaker and an implantable cardioverter-defibrillator (ICD), which can shock your heart back to a normal rhythm. To learn more about ICDs, see Heart Problems: Living With an ICD.
- 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.
- 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.
- Have your pacemaker checked regularly to make sure it is working right.
When you have a pacemaker, it's important to avoid strong magnetic and electrical fields. The lists below show some electrical and magnetic sources and how they may affect your pacemaker. For best results, follow these guidelines. These safety tips also apply to devices that combine an ICD and a pacemaker. If you have questions, check with your doctor.
Your doctor or the manufacturer of your pacemaker can give you a full list of things that you need to avoid and things that are safe to use.
Stay away from:
Use with caution:
Safe to use:
Having medical tests and procedures
Most medical tests and procedures won't affect your pacemaker, except for MRI, which uses strong magnets. To be safe:
- Let your doctors, dentists, and other health professionals know that you have a pacemaker before you have any test, procedure, or surgery.
- Have your dentist talk to your doctor before you have any dental work or surgery.
- If you need physical therapy, have the therapist contact your doctor before using ultrasound, heat therapy, or electrical stimulation.
You can travel safely with a cardiac device. But you'll want to be prepared before you go.
- Bring a list of the names and phone numbers of your doctors.
- Bring your cardiac device identification card with you.
- Know what to do when going through airport security.
You can drive if you have a pacemaker and you don't have any symptoms such as fainting. But right after you get a pacemaker, your doctor will likely ask you to not drive for at least a week after the device is implanted. This gives you time to heal.
Letting others know
- Carry a pacemaker identification card with you at all times. The card should include manufacturer information and the model number. Your doctor can give you an ID card.
- Wear medical alert jewelry stating that you have a pacemaker. You can buy this at most drugstores or online.
- Go to all your appointments with your doctor to check your pacemaker. In between checkups, you will probably send information from your pacemaker to your doctor through a phone line or the Internet. You might do this manually or your device might do it automatically.
- If you take heart rhythm medicines, take them as prescribed. The medicines work with your pacemaker to help your heart keep a steady rhythm.
- Your doctor and/or the device maker will contact you about what to do if your device is recalled.
Pacemakers often are used to improve your ability to exercise. Most people with pacemakers have active lives and can exercise. Talk to your doctor about the type and amount of exercise and other activity you can do.
- You may need to limit your activity if you have an irregular heart rate caused by heart failure or another heart problem.
- Don't play contact sports, such as soccer or basketball, because the device can be damaged. Sports such as swimming, running, walking, tennis, golf, and bicycling are safer.
- If you want to do strength-training exercises, ask your doctor or a fitness trainer to suggest ones that are safe for someone who has a pacemaker. Some exercises might put too much strain on your device.
Most people who have a pacemaker can have an active sex life. After you get a pacemaker implanted, you'll let your chest heal for a short time. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.
Talk with your doctor if you have any concerns.
Planning for the future
As you plan for your future and your end of life, you can include plans for your pacemaker. You can make the decision to turn off your pacemaker as part of the medical treatment that you want at the end of life. You can put this information in your advance directive.
When to call a doctor
Call your doctor right away if you have symptoms that could mean your device isn't working properly, such as:
- Your heartbeat is very fast or slow, skipping, or fluttering.
- You feel dizzy, lightheaded, or faint.
- You have shortness of breath that is new or getting worse.
Call your doctor right away if you think you have an infection near your device. Signs of an infection include:
- Changes in the skin around your device, such as swelling, warmth, redness, and pain.
- An unexplained fever.
Other 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.
- Lampert R, et al. (2010). HRS Expert Consensus Statement on the Management of Cardiovascular Implantable Electronic Devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. Heart Rhythm, 7(7): 1008–1026. Available online: http://www.hrsonline.org/Policy/ClinicalGuidelines/upload/ceids_mgmt_eol.pdf.
- Lee S, et al. (2009). Clinically significant magnetic interference of implanted cardiac devices by portable headphones. Heart Rhythm, 6(10): 1432–1436.
- Levine GN, et al. (2012). Sexual activity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 125(8): 1058–1072.
- 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/Practice-Guidance/Clinical-Guidelines-Documents/HRS-EHRA-Expert-Consensus-on-the-Monitoring-of-Cardiovascular-Implantable-Electronic-Devices/2008-Monitoring-of-CIEDs.
Last Revised: June 12, 2013
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