Living With a Pacemaker or Implantable Cardioverter Defibrillator (ICD)
Living with a pacemaker or ICD:With advances in technology, implanted pacemakers and ICDs generally last several years (depending upon usage and the type of device) and, in most cases, allow a child to lead a normal life. In addition, advances in device-circuitry and insulation have reduced the interference risk from electronic equipment and appliances, 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 child has an implanted pacemaker or ICD.
What precautions should be taken with an implanted pacemaker or ICD?Your child should wear a medical identification bracelet or necklace to let others know about the device in case of emergency. When he/she is old enough to have a wallet, it is a good idea to also carry an ID card.
According to The American Heart Association and pacemaker manufacturers, the following items have not been shown to alter the function of today's pacemakers or ICDs:
- microwave ovens
- kitchen appliances such as blenders, toaster ovens, and electric knives
- televisions (including the remote control), FM and AM radios, and stereos
- TV and radio transmitters
- ham radios and CB radios
- electric blankets and heating pads
- electric shavers, hair dryers, curling irons, and other personal care appliances
- gardening machinery, such as electric trimmers
- garage door openers
- metal detectors
- copying and fax machines
- properly grounded shop tools (except power generators or arc welding equipment)
Make sure your child uses caution when going through security detectors at airports and government buildings such as courthouses. Pacemakers and ICDs should not be affected by these security devices, as long as its wearer moves through and away from the detector at a normal speed. Check with your child's physician about the safety of going through such detectors with your child's particular device. The metal in the pacemaker or ICD may activate a security alarm, however. Be prepared to show an identification card or a medical identification bracelet in order to pass through security checkpoints.
The following situations may cause interference with implanted cardiac devices. (Some of the activities mentioned are not appropriate until a child nears adulthood, but may affect older teenagers.) Discuss the following in detail with your child's physician:
- Avoid working with, holding, or carrying strong magnets near the pacemaker or ICD.
- Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields, since the device's performance can be affected. Also, metal objects are not permitted near MRI machines.
- 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, as they may temporarily "confuse" the device. Do not use chain saws, because of the close contact with the motor components.
- Avoid certain high-voltage or radar machinery, such as arc welders, high-tension wires, radar installations, smelting furnaces, electric steel furnaces, and other high-current industrial equipment. Avoid working in restricted spaces near radio or television transmitting towers and antennas.
- If your child is having a surgical procedure performed by a surgeon or dentist, tell the surgeon or dentist that your child has a pacemaker or ICD. Some surgical procedures will require that your child’s ICD be turned off; however, this will be determined by your child’s physician.
- extracorporeal shock-wave lithotripsy (ESWL) - a procedure that dissolves kidney stones.
- radiofrequency ablation - a procedure that uses radio waves to control irregular heart rhythms.
- transcutaneous electrical nerve stimulation (TENS) - a device used to relieve acute or chronic pain.
- therapeutic radiation treatments for cancer
Always consult your child's physician if you have any questions concerning the use of certain equipment near your child's pacemaker.
Can my child participate in regular, daily activities with a pacemaker?Once the device has been implanted, your child should be able to do the same activities everyone else in their age group is doing: living normally.
However, when involved in a physical, recreational, or sporting activity, a child with a pacemaker or ICD should avoid receiving a blow to the skin over the device. A blow to the chest or abdomen near the pacemaker or ICD could fracture the pacing wire(s) and affect its functioning. Contact sports are usually not recommended for children with pacemakers or ICDs for this reason. If your child does receive a blow to that area, contact your child's physician. Consult your child's physician for activity restrictions.
Always consult your child's physician when he/she feels ill after an activity, or when you have questions about beginning a new activity.
How can I ensure that my child's pacemaker or ICD is working properly?Although your child's device is built to last several years, always have it checked regularly to ensure that it is working properly. Different physicians may have different schedules for checking devices, and some can be checked in the home using a telephone and special equipment provided by your child’s device manufacturer.
Battery life, lead wire condition, and various functions are checked by performing a device interrogation. During an interrogation, the device is connected to a computer using a magnet and a special machine.
Your physician may ask you to check your child’s pulse rate periodically. Report any unusual symptoms, or symptoms similar to those your child had prior to the device insertion, to your child’s physician immediately.
Always consult your child's 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, and this can be felt in various points in the body as a pulse. Taking a pulse not only measures the heart rate, but also can indicate the following:
- heart rhythm (abnormal rhythm may indicate a heart disorder)
- strength of the pulse (a weak pulse may indicate a fast heartbeat in which some beats are too weak to feel, heart failure, or a low volume of blood in the circulatory system)
How to check your child's pulse:As the heart forces blood through the arteries, 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 a 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 the 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 you have trouble with this method, try a digital kitchen timer and set it for one minute. Stop counting when the timer alarms.
- If unsure about your results, ask another person to count for you.
The information on this Web page is provided for educational purposes. You understand and agree that this information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You agree that Lucile Salter Packard Children's Hospital is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances through the use of this Web page. You agree to be solely responsible for your use of this Web page and the information contained on this page. Lucile Salter Packard Children's Hospital, its officers, directors, employees, agents, and information providers shall not be liable for any damages you may suffer or cause through your use of this page even if advised of the possibility of such damages.