Home Treatment & Recovery Living with an ICD

Living with an ICD

How often does the ICD need to be checked?

The ICD needs to be checked periodically to make sure it is working properly, first in the hospital after the procedure and then by your doctor at his or her office every few months. She or he will let you know how often you need to make an appointment to get the ICD checked.

To check the ICD, the doctor will place a special magnetic wand over the device, which you will not feel. The ICD contains data on your heart rhythm and any pacing or shocks the device delivered so it can be adjusted if necessary. Your doctor can also tell if the battery on the ICD is running low. ICD batteries usually last 5 to 7 years, depending on how many shocks it has to deliver. The battery will not just stop working, but will emit a signal for 6 months before it is due to run out. Your doctor will detect this with the wand during the regular checkups and schedule a procedure to replace your ICD.

How do I know if my ICD is working and what will I feel if it delivers a shock?

Your ICD is constantly monitoring your heart rhythm to make sure it is normal. You will not feel anything during this normal monitoring, but your doctor will be able to check your ICD during your regular follow-up appointments.

Your doctor will program the ICD to respond differently to different heart rhythm problems. You will not typically feel pacing, when the ICD attempts to take over your heart’s rhythm with a series of small electrical impulses. Cardioversion, when the ICD delivers a small shock at the same time as your heart beats, can feel like a small "thump" in the chest (like an especially strong heartbeat). If your heartbeat becomes dangerously fast or disorganized, the ICD will deliver a large defibrillation shock. This can be painful, and is described by patients as feeling as if they have been "kicked in the chest." Defibrillation shocks last only a second.

What should I do if I receive a shock?

If you receive a defibrillation shock, you should call your doctor or go to the emergency room. Try to remain calm. If possible, ask someone to stay with you for a little while. Although painful, the ICD may have just saved your life. Follow any instructions that your doctor has given you.

What can go wrong with an implanted ICD?

The most common problem patients with an ICD experience is when the device delivers a shock when it was not needed. As many as 1 in 4 patients with an ICD experience unnecessary shocks.17,18 It is not clear if this is more common in women: some studies have shown that women experience more unneeded shocks, others that this problem is equally common in women and in men.11,13,19-21 If you believe you are receiving unnecessary shocks, let your doctor know: she or he may be able to adjust the ICD so that the shocks do not happen as often while still protecting you. Your doctor will also be able to tell if you have received unnecessary shocks by looking at the data stored on the device.

Even when shocks are given appropriately, the fear of experiencing an ICD shock can affect quality of life for some people. The more shocks someone receives, the more depression and anxiety about the shocks are likely to be an issue.22 Women may experience anxiety about the device more often than men and have more ICD concerns, but they are no more likely to be depressed and just as likely as men to accept the device.23, 24

Despite the stress posed by the prospect of ICD shocks, most studies find that patients with an ICD have a similar quality of life as those who are treated with medication alone.25 In one trial of more than 2500 patients (23% were women) that compared ICD implantation with state-of-the-art medical treatment, ICD patients actually had a better quality of life at 3 months and 1 year, while there were no differences between the two groups after 30 months (no sex-specific data was reported).26

Rarely, an ICD may malfunction to the point that is has to be removed. Between 1990 and 2002, 415,780 patients had ICDs implanted, and 8489 (2%) had to be removed.27

I have been hearing a lot about ICD recalls. Should I be concerned?

The Food and Drug Administration is responsible for making sure that ICD devices are safe for use, and it issues recalls when there is some concern about a device’s safety. The term "recall" is used when a medical device is defective or is a risk to a patient’s health. There are different levels of recalls depending on how serious the problem is. A recall does not necessarily mean you will have to have the device removed—in some cases, it simply means your doctor will have to monitor your ICD more carefully.

If you hear about an ICD recall, you can find out more on the FDA website at www.recalls.gov. You can also sign up to receive free e-mail alerts about recalls. To find out if a recall affects your device, compare information found on the FDA site to the information on the ICD card you were given or mailed. If they match call your doctor to find out what, if anything, needs to be done.

I have an ICD. What should I watch out for?

Because strong electrical and magnetic fields can affect the function of your ICD, you should take precautions to avoid them:

  • Avoid getting too close to areas or machines that emit strong electric or magnetic fields (for example, stereo speakers)
  • Most everyday appliances like microwaves are safe, but you should avoid prolonged close exposure
  • If you are unsure whether a machine is safe, keep at least 6 inches between your ICD and the machine
  • The 6-inch rule also applies to portable electronic devices such as cell phones and iPods; use the ear opposite your ICD to talk on the phone, and don’t store devices in your breast or jacket pocket
  • Airport metal detectors are safe, but the handheld metal detector wands should NOT be held near the ICD
  • Be sure to tell doctors or medical technicians about your ICD before having any tests
    • X-rays and CT scans are safe
    • MRIs are NOT SAFE because they contain a strong magnetic field

Write down any specific safety questions that occur to you so you can ask your doctor.

Do I still need to take my heart rhythm drugs after I get an ICD?

Although most women with heart failure who have an implanted ICD do not require heart rhythm drugs, your doctor may keep you on some medications, such as amiodarone, sotalol, or dofeditilide, even after you have an ICD. These drugs can prevent heart rhythm disturbances that could cause you to receive an ICD shock.


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  11. Russo AM, Day JD, Stolen K, et al. Implantable Cardioverter Defibrillators: Do Women Fare Worse Than Men? Gender Comparison in the INTRINSIC RV Trial. J Cardiovasc Electrophysiol. May 12 2009.
  12. Pires LA, Sethuraman B, Guduguntla VD, Todd KM, Yamasaki H, Ravi S. Outcome of women versus men with ventricular tachyarrhythmias treated with the implantable cardioverter defibrillator. J Cardiovasc Electrophysiol. Jun 2002;13(6):563-568.
  13. Zareba W, Moss AJ, Jackson Hall W, et al. Clinical course and implantable cardioverter defibrillator therapy in postinfarction women with severe left ventricular dysfunction. J Cardiovasc Electrophysiol. Dec 2005;16(12):1265-1270.
  14. El-Chami MF, Hanna IR, Bush H, Langberg JJ. Impact of race and gender on cardiac device implantations. Heart Rhythm. Nov 2007;4(11):1420-1426.
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  16. Peterson PN, Daugherty SL, Wang Y, et al. Gender differences in procedure-related adverse events in patients receiving implantable cardioverter-defibrillator therapy. Circulation. Mar 3 2009;119(8):1078-1084.
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  24. Bilge AK, Ozben B, Demircan S, Cinar M, Yilmaz E, Adalet K. Depression and anxiety status of patients with implantable cardioverter defibrillator and precipitating factors. Pacing Clin Electrophysiol. Jun 2006;29(6):619-626.
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