Getting a heart device is a major step toward regaining your health and independence. Whether you've been diagnosed with a slow heart rate or are at risk for serious heart rhythms, these small but powerful devices work constantly to keep your heart in sync.
At NewYork-Presbyterian, we want you to feel confident moving forward. Most of our patients find that once they heal, they can do almost everything they did before. It’s about balance: staying active while knowing a few simple precautions to keep your device working perfectly.
What Is a Pacemaker?
What Is a Pacemaker?A pacemaker is a small, battery-powered device implanted under the skin, usually just below the collarbone. It monitors your heart’s electrical activity through thin wires called leads. If your heart beats too slowly (bradycardia) or skips beats, the pacemaker sends tiny, painless electrical signals to keep it on track.
Living With a Pacemaker
Living with a pacemaker means having a continuous "backup system" for your heart. Most patients find that after the initial healing period of about four to six weeks; they forget the device is even there. It allows you to feel more energetic and reduces symptoms like dizziness, fainting, or shortness of breath caused by a slow heartbeat. Modern pacemakers are very durable.
What Is an ICD (Implantable Cardioverter Defibrillator)?
What Is an ICD (Implantable Cardioverter Defibrillator)?An ICD is similar to a pacemaker, but with an additional critical function. While it can function as a pacemaker to prevent a slow heart rate, its main job is to detect life-threatening, rapid heart rhythms (ventricular tachycardia or fibrillation). If the device senses a dangerous rhythm that could lead to sudden cardiac arrest, it delivers a life-saving shock to reset the heart to a normal pace.
ICD vs Pacemaker
When comparing an ICD vs a pacemaker, the main difference is the "rescue" function. A pacemaker only prevents the heart from going too slow. An ICD can "defibrillate" or shock the heart if it beats dangerously fast.
Your cardiologist will recommend the specific device based on your unique heart rhythm history and your risk for sudden cardiac arrest. Many ICDs also include all the features of a pacemaker, providing added protection for many types of arrhythmias.
Activity and Exercise With a Pacemaker or ICD
Activity and Exercise With a Pacemaker or ICDKeeping your body moving is one of the best ways to care for your heart. Once your incision has fully healed, usually after a few weeks, you can typically return to your normal routine. Exercise helps strengthen the heart muscle and improves the effectiveness of your device treatment.
Exercise With a Pacemaker
When it comes to exercise with a pacemaker or ICD, most activities are encouraged, including walking, swimming, and golfing. However, we recommend a phased approach:
- The First Month: Focus on gentle walking. Avoid excess motion with the arm on the side of the pacemaker, meaning no big swings or carrying heavy objects. This prevents the leads (wires) from being pulled from their positions before they have firmly attached to the heart tissue.
- Long-term Fitness: Once cleared by your care team, you can return to more vigorous activities. Cardiovascular exercise is generally safe and highly recommended.
- Avoiding Contact Sports: Activities like football, soccer, or karate could result in a direct blow to the chest, which might damage the device or the leads. If you are an athlete, talk to your electrophysiologist about protective gear or device options that can avoid direct contact.
Pacemaker Restrictions and ICD Restrictions
General pacemaker and ICD restrictions focus mostly on avoiding direct impact and extreme strain during the healing phase.
- Weight Limits: Avoid heavy lifting (usually anything over 10–15 pounds, like a heavy bag of groceries or a child) for the first four weeks post-surgery.
- Repetitive Motion: Avoid excessive, repetitive over-the-head motions (like a tennis serve, golf swing, or a swimming crawl stroke) until your doctor confirms the leads are stable.
- Proximity to Machinery: Be aware of vibration. Some high-power industrial tools can cause a "vibration" that the device might misinterpret as a heart rhythm issue.
Travel and Airport Security with Your Device
Travel and Airport Security with Your DeviceWhen planning travel with pacemaker or ICD, your most important item is your Device Identification Card. This card contains the manufacturer of your device and the settings chosen by your doctor.
- Airport Security: Metal detectors will not damage your device, but the metal in the pacemaker may set off the alarm. Show your ID card to security personnel and ask for a manual search or a "pat-down."
- Full-Body Scanners: Advanced imaging technology (AIT) scanners used at most airports are safe for patients with pacemakers and ICDs.
- Hand-held Wands: If a hand-held wand is used, ask the agent not to hold it directly over your device for more than a second or two. The magnet inside the wand can temporarily affect the device's programming.
- In-flight Safety: There are no restrictions on flying; the cabin pressure and plane electronics do not affect device function.
Everyday Devices and Magnets: What’s Safe, What to Avoid
Everyday Devices and Magnets: What’s Safe, What to AvoidMost household appliances, such as microwaves, toasters, and televisions, are perfectly safe. The main concern for patients with a heart device is "electromagnetic interference" (EMI) from strong magnets or large electrical fields.
Pacemaker, Electric fields, and Magnets
Knowing how machines can affect your pacemaker is important for staying safe in everyday life. Strong electromagnetic fields can "trick" your device into thinking your heart is beating when it isn't, or they can cause an ICD to temporarily suspend its ability to shock, or cause a shock when it isn’t needed.
- Cell Phones: Keep your phone at least 6 inches away from your device. Do not carry your phone in a breast pocket directly over the pacemaker. Use the ear opposite your implant.
- Headphones: Many headphones contain magnets. When not in use, do not drape them around your neck so they hang near your chest.
- Anti-Theft Systems: When walking through department store security sensors, walk through at a normal pace. Do not linger or lean against the sensors.
- Power Tools: Most small household power tools (drills, sanders) are safe. However, avoid leaning over running engines (like a car alternator) or using industrial-grade arc welders and chainsaws without a specific consultation with your specialist.
Pacemaker and MRI
Historically, pacemaker and MRI scans were strictly prohibited. However, most modern devices used at NewYork-Presbyterian are "MRI-conditional." This means you can safely have an MRI under specific controlled conditions.
Important: Always inform your imaging technician and your cardiologist before scheduling an MRI. Our team must program your device into a special "MRI Mode" before the scan and return it to its normal settings immediately afterward.
Device Checks, Remote Monitoring, and Follow-Up
Device Checks, Remote Monitoring, and Follow-UpAt NewYork-Presbyterian, we use advanced remote monitoring technology. This allows your device to "talk" to our clinic from the comfort of your home.
A small monitor by your bedside automatically sends data about your heart rhythm and the device’s battery life to your care team. Even with remote monitoring, you will still have periodic in-person visits at our Device Clinic to ensure everything is working properly and the device is tuned to your needs.
When to Call Your Doctor — and When to Call 911
When to Call Your Doctor — and When to Call 911Knowing how to triage your symptoms is essential for living with a heart device.
Call your NewYork-Presbyterian care team if:
- The incision site looks red, swollen, hot, or is draining fluid (signs of infection).
- You experience frequent hiccups that won’t stop (this can indicate a lead is irritating the diaphragm).
- You feel dizzy, lightheaded, or your heart feels like it is "racing" despite the device.
- Your ICD fires a shock: Even if you feel fine afterward, you should notify your doctor as soon as possible so we can review the data transmitted by your device.
Call 911 immediately if:
- You feel a "storm" of multiple shocks from your ICD in a short period.
- You experience severe chest pain or sudden, extreme shortness of breath.
- You faint or feel like you are about to pass out.
Expert Care at NewYork-Presbyterian
Our world-class arrhythmia and electrophysiology programs offer the latest in device technology and personalized heart rhythm management. By choosing NewYork-Presbyterian, you are gaining access to a multidisciplinary team of experts dedicated to ensuring your device works for your life.
To schedule a follow-up, discuss a device upgrade, or learn more about our specialized monitoring services, please visit our Device Clinic and Contact Information page.
This content has been reviewed by the following medical editors.