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How do WCDs work? Who needs an AED? Who needs an ICD? If you have the following conditions, you may be at risk for a life-threatening arrhythmia and your doctor may recommend an ICD: You survived sudden cardiac arrest.

You developed an arrhythmia during or after treatment for a heart attack. You have a genetic condition that causes arrhythmia. This includes having congenital heart disease or an inherited conduction disorder.

You have a neuromuscular disorder. For example, the progression of muscular dystrophy can damage the heart and cause unpredictable heart rhythms.

This can lead to unexplained fainting and a high risk of death. You have cardiac sarcoidosis. You have poor heart function following a procedure to improve blood flow.

Your doctor detected an arrhythmia during an electrocardiogram EKG or stress test. If this happened several times, you may be at increased risk.

Who needs a WCD? This might occur under these conditions: You are recovering from a heart attack.

You are waiting for a heart transplant. You are fighting an infection. You are removing or waiting to replace your ICD.

Using an AED in an Emergency. When to use an AED. If you think someone may be in cardiac arrest, try the following steps: If you see a person faint or if you find a person already unconscious, first confirm that the person cannot respond.

The person may not move, or his or her movements may look like a seizure. You can shout at or gently shake the person to make sure he or she is not sleeping, but never shake an infant or young child.

Instead, you can gently pinch the child to try to wake him or her up. If the person is not breathing and has no pulse or has an irregular heartbeat, prepare to use the AED as soon as possible.

Where to find an AED. How to use an AED. When using an AED: Call or have someone else call If an electric pulse or shock is needed to restore a normal rhythm, the AED uses voice prompts to tell you when and how to give the shock, and electrodes deliver it.

Some AEDs can deliver more than one shock with increasing energy. The device may instruct you to start CPR again after delivering the shock.

Before and during surgery. Follow the instructions you receive. Your healthcare team may tell you to take these steps: Check the cut on your chest often and keep the area clean and dry.

Call your doctor if any swelling or bleeding occurs or if you develop a fever. Take over-the-counter pain medicines such as acetaminophen if you feel pain.

But talk to your doctor first; he or she may tell you to avoid taking ibuprofen or other kinds of pain medicines, for example.

Ask your doctor when you can resume taking medicines that you took before the surgery, how soon you can take a shower, and when you can return to work.

You will probably have to avoid driving for at least a week while you recover from your surgery. Your doctor may also ask you to avoid high-impact activities and heavy lifting for about a month.

Although they are rare, possible complications include: A bad reaction to the medicine used to make you relax or sleep during the surgery A collapsed lung A defibrillator wire puncturing the heart or a vessel Bleeding from the site where the device was placed Blood vessel, heart, or nerve damage Swelling, bruising, or infection at the area where the device was placed Venous thromboembolism Some ICD models have a lower risk of clots, puncture, and infection.

Living With to learn more about your recovery and life after you return home. Research for Your Health will explain how we are using current research and advancing research on defibrillators.

What to expect from electric shocks. The low-energy electrical shocks your device gives are not painful. You may not notice them, or you may feel a fluttering in your chest.

The high-energy shocks last only a fraction of a second, but they can be strong or painful. They may feel like thumping or a kick in the chest, depending on their strength.

Before a shock, you may feel arrhythmia symptoms. If you feel one or two strong shocks over a short period and the symptoms go away, it may be a sign that the device is working.

He or she will want to assess your condition and the device. During the adjustment period after your surgery, your device may deliver a shock when it is not needed.

A damaged wire or a very fast heart rate due to extreme physical activity may trigger unnecessary shocks. These shocks can also occur if you forget to take your medicines.

Some people also feel phantom shocks, even when the device does not detect an arrhythmia. Make sure your WCD is fitted properly.

Return to normal daily activities. An ICD usually will not limit you from taking part in sports and exercise, including strenuous activities.

You may need to avoid full-contact sports, such as football. Contact sports can damage your ICD or shake loose the wires in your heart.

Ask your doctor how much and what types of physical activity are safe for you. You probably will be able to resume your typical driving patterns after you recover from surgery.

However, if you received an ICD to prevent another sudden cardiac arrest or ventricular arrhythmia , it will probably be several months before your doctor says you are ready to drive again.

This is because of the risks of fainting or getting a shock from your device. Your doctor may also suggest driving restrictions based on the activity recorded by your device.

Receive routine follow-up care. At the follow-up visits, your doctor may also take these steps: Prescribe or adjust your medicines to decrease the number of irregular heartbeats you have.

Fewer irregular beats will mean fewer high-energy shocks that have to be sent to your heart. Check to make sure the device continues to work properly and that it has not shifted in your body or caused irritation or injury.

Over time, your ICD may stop working well because its wires get dislodged or broken, its battery fails, your heart disease progresses, or other devices have disrupted its electrical signaling.

Check to see whether you are at risk of heart failure. If device and medicine adjustments do not reduce your irregular heart rhythms, your doctor may suggest a procedure called ablation to stop excess electrical signals in your heart.

Check to see whether the battery needs to be replaced. Batteries in ICDs last between five and seven years. When the batteries in your device run down, you will need surgery to replace them.

Replacing the battery is less involved than the original surgery to implant the ICD. Ask your doctor whether the device generator or its wires need to be replaced, too.

Manage devices that can interfere with your ICD. To be safe, keep your ICD at least six inches away from the following devices, or, when necessary, use them only briefly: If you have an ICD on the left side of your chest, hold your cell phone to your right ear.

Most headphones have a magnetic element in them. Wear them as far away from your ICD as possible, and do not carry your headphones in a chest pocket.

Metal detectors, such as those used for airport security. The risk of harm is low, but you can show your ID card and ask for alternative inspection.

Learn the warning signs of complications and make a plan. Call your doctor if you have signs of symptoms that concern you, and if you have these signs in particular: Fainting Dizziness or feeling out of breath Fever Heart palpitations or chest pain Go to a hospital emergency room if you feel many strong shocks from your device in a short time.

Tend to your emotional health. Return to Who Needs Them? Research for Your Health. Improving health with current research. Advancing training in emergency care.

This program will support young investigators who are committed to research careers in emergency cardiovascular medicine. Funding advances in emergency response.

The Resuscitation Outcomes Consortium ROC is a clinical trial network that tests treatments to address high rates of injury and death from out-of-hospital cardiac arrest and severe traumatic injury.

Researchers are comparing how emergency response teams transport patients to the hospital to look for ways to improve outcomes.

A registry of sudden cardiac arrests that ROC established has helped track important information about these events. In , ROC data helped show that more patients survive sudden cardiac arrest in public spaces when bystanders use an AED while waiting for a standard emergency response.

In addition, patient outcomes were better when bystanders used an AED. Promoting a clinical trial network to address emergency medicine.

Helping show how AEDs can save lives. Our Public Access Defibrillation trial helped show the value of having AEDs in public spaces by showing they could increase survival among people experiencing sudden cardiac arrest.

Researchers found that more people experiencing sudden cardiac arrest survived when teams of volunteers trained in CPR and AED use responded, compared with volunteer responders trained in CPR only.

We funded research that showed that for patients with mild or moderate congestive heart failure and a weakly pumping heart, conventional heart failure treatment paired with a simple ICD therapy is more effective than the conventional treatment alone.

Survival rates were 23 percent higher among patients with an ICD. Supporting heart failure research collaboration.

The HFN brings together nine Regional Coordinating Centers and additional clinical sites in the United States to form a collaborative platform to research strategies that address the increasing public health burden of heart failure.

Assessing optimal use of AEDs. Advancing research for improved health. Specific projects aim to answer clinically relevant questions in diagnostics, therapeutics, and interventions.

The Heart Failure and Arrhythmia Branch within the DCVS supports research to advance our understanding of and interventions for pediatric and adult cardiovascular diseases.

We also support the development of innovative technologies to diagnose, prevent, and treat heart and vascular diseases.

The Center for Translation Research and Implementation Science supports research to translate these discoveries into clinical practice.

We stimulate high-impact research. Findings from TOPMed may help us understand how genes contribute to the development of atrial fibrillation—for example, in women and in patients who have no underlying heart disease.

Using genetic information to assess risk of complications. Some genetic conditions can be treated with an ICD to monitor and correct abnormal heart rhythms.

However, even people with the same genetic pattern do not all have the same risk of developing a life-threatening arrhythmia. Although high-energy shocks are effective therapy for arrhythmias, they can startle patients and cause them distress or pain.

Are you considering getting or replacing an implantable cardioverter defibrillator? Implantable cardioverter defibrillators ICDs can present patients with many stressful decisions, and this study tests the effectiveness of educational videos and handouts to inform patients about ICDs and help them assess their options.

To participate in this study, your doctor must have given you the option of implanting or replacing an ICD. The study is located in Denver, Colorado.

This study is examining how hospital procedures affect outcomes for patients who are brought to an emergency department after being resuscitated from sudden cardiac arrest.

To participate in this study, you must be between 18 and 75 years old and have had a ventricular arrhythmia that caused a sudden cardiac arrest.

Paul, Minnesota, and in Milwaukee, Wisconsin. This study will investigate health outcomes among people with a heart conduction disorder that is sometimes treated with an implantable cardioverter defibrillator.

To participate in this study, you must be between 18 and 60 years old and have complete left bundle branch block. The study takes place in Beijing, China.

This study aims to understand which patients are at the greatest risk of sudden cardiac death. This will help doctors determine which patients will benefit from having their implantable cardioverter defibrillator ICD replaced.

To participate in this study, you must be 18 to 85 years old, currently have an ICD, and meet certain criteria for heart function.

This study aims to learn what signs distinguish patients who have a higher risk of an arrhythmia that leads to sudden cardiac arrest. Researchers plan to track patients with a recent ICD replacement for 10 years.

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