Implantable Defibrillator Offers an Improved Quality of Life
Implantable cardioverter-defibrillators (ICDs) help heart disease patients live longer, lead more active lives, and enjoy a quality of life comparable to that of average Americans, according to a study in the journal Pacing and Clinical Electrophysiology.
The study also concludes that patients with ICDs - electronic monitoring devices that deliver a lifesaving shock to the heart in the event of cardiac arrest - have a high level of satisfaction with the units.
This finding offsets longstanding perceptions that ICDs extend, but seriously impair, patients' lives.
Patients should be optimistic about returning to normal life after an ICD is implanted, says study author Dr. Peter Groeneveld, assistant professor of general internal medicine, University of Pennsylvania School of Medicine.
The use of ICDs has rapidly increased in recent years, particularly since Medicare and other health payers expanded coverage of the device for primary prevention. "Primary prevention" refers to those who have no prior history of abnormal heart rhythms but whose heart disease may increase their risk of sudden cardiac death.
Nearly 50,000 implants were performed in 2005 in the US alone, making it among the most common cardiovascular device used in contemporary clinical practice.
In the new study, researchers found that patients reported high levels of emotional, physical, and functional well-being and said they were satisfied and able to adapt to living with the ICD.
In addition, the study revealed that driving, lifting heavy objects, and sexual activity were the most common lifestyle concerns among ICD patients. The researchers say that physicians should discuss these issues with patients.
The researchers say their study is the first to look at quality of life and cost in "primary prevention" ICD patients.
"While the lifesaving benefits of ICDs have been well documented over the last decade, little was known about the experience of patients in the real world, post implantation," says Dr. Groeneveld.
"This study looked at a population that better represents current device recipients, which, in turn, means that physicians can now communicate a more accurate description of life with the device to patients," says Dr. Groeneveld.
According to Dr. Groeneveld, the quality of life benefits emerge from advances in ICD technology over the last decade resulting in smaller, more easily programmed devices which can more accurately respond to the needs of the individual patient.
"With an estimated one million Americans eligible for implantation today, it is extremely important to verify that ICDs deliver value on par with the health care dollars expended in most heart patients, even among the elderly," he says.
Always consult your physician for more information.
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With advances in technology, pacemakers and ICDs generally last several years (depending upon usage and the type of device) and, in most cases, allow a person 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 person has a pacemaker or ICD.
The following precautions should always be considered:
- Use caution when going through airport security detectors. Check with your physician about the safety of going through such detectors with your particular device.
- Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields.
- 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 (they may temporarily "confuse" your device).
- Avoid certain high-voltage or radar machinery, such as radio or television transmitters, electric arc welders, high-tension wires, radar installations, or smelting furnaces.
- If you are having a surgical procedure performed by a surgeon or dentist, tell your surgeon or dentist that you have a pacemaker or ICD, so that electrocautery will not be used to control bleeding (electrocautery can interfere with the pacemaker or ICD).
- Always carry an ID card that states you have a pacemaker/ICD. It is recommended that you wear a medic alert bracelet or necklace if you have a device.
- You may have to take antibiotic medication before any medically invasive procedure to prevent infections.
Always consult your physician if you have any questions concerning the use of certain equipment near your pacemaker/ICD.
Once the device has been implanted, people with pacemakers/ICDs should be able to do the same activities everyone else in their age group is doing. When you have a pacemaker/ICD, you may still be able do the following:
- exercise moderately, upon advice from your physician
- drive your car or travel if cleared by your physician
- return to work
- work in the yard or house
- participate in sports and other recreational activities
- take showers and baths
- continue sexual relationships
When involved in a physical, recreational, or sporting activity, a person with a pacemaker/ICD should avoid receiving a blow to the skin over the device.
Always consult your physician for more information.
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