Physical activity with an ICD
For most patients it is safe to exercise and to take part in sport. Indeed, research has shown that physical activity and exercise are beneficial for people fitted with an ICD.
Individual cases are influenced by the cause and type of your heart rhythm problems and the type of exercise you perform. Your clinicians will be able to advise you of any exercise-related information that is specific to your situation. 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, with- out a cool down or active recovery period you increase the likelihood of arrhythmia.
Your ICD can detect an abnormal heart rhythm 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 anything other than recreational exercise or exercise to lose weight.
If you are concerned about your safe exercise level, you should ask your cardiologist, cardiac physiologist or arrhythmia/ICD nurse specialist.
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 the DVLA website: http://www.direct.gov.uk/en/Motoring/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).
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.
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.