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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 machinery, 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:

Currently, cellular phones do not affect the functioning of pacemakers or ICDs. Most devices made today have a filter that allows the use of the majority of cellular phones used throughout the world, including analog and digital technologies. However, new frequencies are being made available for cellular phones by the Federal Communications Commission, and these new frequencies may make pacemakers less reliable. Studies are being done to investigate this further.

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:

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:

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.

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 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:

Many pacemakers provide varying rates, depending on your child's activity level and other factors. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions. Girls ages 12 and older and women, in general, tend to have faster heart rates than do boys and men. Athletes, such as runners, who do a lot of cardiovascular conditioning may have slow heart rates and experience no problems.

How to check your child's pulse:

Illustration demonstrating how to take a 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:

If you are having difficulty in finding your child's pulse, consult your child's physician for additional instruction.

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