Royal Sussex County Hospital. Princes Royal Hospital. Hove Polyclinic. Sussex Universities



Physical activity and exercise advice for patients with an
Implantable Cardioverter Defibrillator (ICD)


Is it safe to exercise?
The simple answer to this question is yes, but the full answer is influenced by the cause and type of your heart rhythm problems and the type of exercise you perform. The likelihood of an arrhythmia is no greater during moderate exercise than during resting but there are certain types of exercise that may increase the risk. If you exercise vigorously from rest, without a warm-up, and immediately cease exercise, without a cool down or active recovery period you increase the likelihood of arrhythmia.

How might exercise affect my ICD?
Your ICD can detect an abnormal heart rhythm (arrhythmia) in a number of ways, one of which relates to the speed of the heart during the arrhythmia. Most arrhythmias treated with ICDs will be significantly faster than your normal heart rate would reach, even with strenuous exercise.

Occasionally however, the ICD needs to be programmed to recognise abnormal heart rates that are close to those that can be achieved with exercise. For this reason, it is worthwhile to check how your ICD is programmed before undertaking anything other than recreational exercise or exercise to lose weight. If you are concerned about your safe exercise level, you should ask your ardiologist, cardiac physiologist or arrhythmia/ICD nurse specialist.

Is there any exercise I definitely can’t do?
For most forms of exercise it is recommended that someone who knows that you have an ICD accompanies you. You should ensure that you have your ICD card with you AT ALL TIMES, in case you need to be taken to hospital for any reason. You should not undertake any contact sports.
Although the ICD itself is very tough, bruising or breaking the skin over the implant site may lead to infection. Swimming can be undertaken once the implant wound has healed fully. You will not be able to take part in any form of competitive motor sport, as you will not be eligible for an appropriate licence. Regular driving should be discussed with your cardiologist. Latest regulations for ICD patients can be found on our DVLA information page or on the DVLA website:
http://www.direct.gov.uk/en/Motor ing/ DriverLicensing/MedicalRulesForDrivers/ index.htm

You should also avoid any sport (or indeed any situation) where you might be exposed to strong
magnetic or electrical fields or a powerful radio source (radio-controlled planes, cars, boats, etc
may be a problem).

So what can I do?
Research has shown that physical activity and exercise are beneficial for people fitted with an ICD. It is likely that your underlying heart condition will have more influence on your ability to exercise than the presence of your ICD. Your underlying heart condition may limit your exercise due to shortness of breath, fatigue or chest pain - these should not be ignored.
Physical activity and exercise should be progressed slowly. The key is to avoid becoming too breathless during exercise, as this will sap your strength and make your heart work too hard. All exercise sessions should start with a warm-up and finish with a cool-down period, both of which should last for approximately ten minutes, so that your body and heart have time to adjust.
In general, most exercises should be performed standing, with horizontal (lying down) and seated arm exercises kept to a minimum. Seated arm exercise with weights may increase the workload on your heart too much leading to an increased likelihood of an arrhythmia.

Summary
Physical activity and exercise can be very useful in helping people with an ICD to become more confident and active. Exercise as described above is safe with a warm up and cool down period.

You should always contact us if you think you have had a shock. Any further questions please contact the Arrhythmia Nurse Specialist on 01273 696955 Ext 7041.

Courtesy of Arrhtyhmia Alliance. Registered Charity No. 1107496 ©2010


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