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
  • computers
  • copying and fax machines
  • properly grounded shop tools (except power generators or arc welding equipment)

Currently, cellular phones do not affect the functioning of pacemakers or ICDs; however, take precaution to keep cellular phones at least 6″ from the device.

Make sure your child uses caution when going through security detectors at airports and government buildings such as courthouses. Pacemakers and ICDs currently being manufactured 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 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.

Certain medical procedures may occasionally affect the function of the device, but might be performed successfully with some adjustments to the pacemaker or ICD settings. These procedures include the following:

  • 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

Consult your child’s physician before your child undergoes these procedures.

Your child may also have to take antibiotic medication before any medically-invasive procedure to prevent infections that may affect the pacemaker.

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 or ICD?

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 pacemaker. A blow to the chest or abdomen near the pacemaker or ICD can 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.