Frequently Asked Questions Everyday questions and answers for patients with an implanted heart rhythm device

1
Frequently Asked QuestionsEveryday questions
and answers for patients with an implanted heart
rhythm device
2
Patients like you have asked about

• Coronary versus carotid artery disease
• Eating green vegetables
• Heart medication continuation
• Body fat measuring devices
• Ultrasonic toothbrushes
• Airport Security
• Traveling
• Device replacement

• Fact or Myth
• See what you know about your implanted device

3
Coronary versus carotid artery disease
Are carotid artery disease and coronary artery
disease caused by the same problem?

• Yes. Both are a result of atherosclerosis, also
  called plaque build-up or blockage.
• In the coronary arteries, it can block blood flow
  to the heart and cause a heart attack.
• In the carotid arteries, it can block blood flow
  to the brain and cause a stroke.

Coronary Arteries
4
Eating green vegetables
After my device implant, my doctor told me not to
eat any green vegetables. Why is that?

• Many pacemaker or defibrillator patients on
  anticoagulants.
• Anticoagulants are also called "blood thinners.
• Help prevent blood clots after your surgery.
• Certain leafy green vegetables are rich in
  vitamin K.
• Vitamin K helps blood to clot and can work
  against anticoagulants.
• Your doctor or pharmacist can answer questions
  about your diet.

5
Heart medication continuation
After my heart attack I had a stent implanted,
and later I had an ICD implanted. Why do I still
have to be on heart medications?

• It depends on what the medications treat.
• Stents are meant to keep a certain part of an
  artery open.
• ICDs are meant to prevent sudden cardiac death
  due to fast or abnormal heartbeats (arrhythmias).
  
• Other cardiovascular problems may be present
• High blood pressure
• Abnormal heart rhythms in your heart's upper
  chambers, the atria
• Coronary artery disease
• Ask your doctor or nurse if you still have
  questions about taking the medications.

6
Body fat measuring devices
I have an implanted defibrillator and recently
joined a gym. They have an electric machine that
measures your body fat. Can I use this?

• Do not usenot at home or at the gym.
• Here's why
• Electric machine sends a low powered electrical
  signal through the body to measure the body fat
  and muscle.
• More muscle more water, which makes it easier
  for electrical signals to pass through your body.
• Electrical signals may be interpreted by your ICD
  or pacemaker as a fast heartbeat signals and
  possibly cause your device to withhold pacing
  therapy or deliver shock therapy that you don't
  need.
• An Alternative
• Body mass index (BMI) uses your height and weight.

7
Ultrasonic toothbrushes
If I have a pacemaker or implanted defibrillator,
can I use an ultrasonic toothbrush at home?

• Use with caution. Maintain
• At least 6 inches (15 cm) between the battery
  charger unit and your cardiac device.
• At least 1 inch (2.5 cm) between the toothbrush
  handle and your cardiac device.
• Here's why
• Electric and ultrasonic toothbrushes emit
  electromagnetic signals.
• Electric signals may be interpreted as fast
  heartbeat signals by your ICD or pacemaker.
• Can possibly cause your device to withhold pacing
  therapy or deliver shock therapy that you don't
  need.

8
Airport Security

• With all the new security at airports, I'm
  thinking about my pacemaker and how I can make
  sure everything goes smoothly.

• Present your Medical Device ID card or Patient
  Travel card to security.
• New security rules focused on checking luggage,
  carry on luggage, taking off your shoes
• Walking through the security archway will not
  harm your device
• May set off alarm, which may prompt a search with
  a wand
• Request hand search or pat-down
• If a wand must be used
• Pass over your device very quickly.
• Wand contains a magnet
• If left over the device, can temporarily affect
  its function

9
Traveling

• How can I find a doctor when I'm traveling?

• Some web resources allow you to enter your
  destination to see a list of medical resources.
• Some web sites focus on locating doctors and
  hospitals.
• www.LifeBeatOnline.com has a search tool for
  overseas travel.

10
Device replacement

• Will my defibrillator ever need to be replaced?

• Eventually, yes.
• Your defibrillator runs on a battery.
• Battery will eventually wear out, based on the
  amount of therapy you receive.
• Battery is checked at each scheduled follow-up
  visit.
• When the battery power reaches a certain point,
  your defibrillator needs to be replaced.
• During the replacement procedure
• ICD is disconnected from the leads
• Leads are checked
• New ICD is connected
• New system is tested

11
Cardiac Device Myths and FactsLets see what
you know about your implanted device
12
Myth or Fact?

• My device is a cure-all for all my heart problems.

• Myth.
• No device is a cure-all for any heart problem.
• Follow your doctors orders for adopting a
  healthy lifestyle.
• Being compliant with your medications.

13
Myth or Fact?

• If I'm touching someone and my ICD delivers a
  shock, that person will be shocked too.

• Myth.
• If touching or holding someone during shock
  delivery.
• A small tingle or buzz the residual energy from
  the therapy may be felt by the other person.

14
Myth or Fact?

• I should not work under the hood of my car while
  the engine is running.

• Fact.
• Driving a car will not affect your device.
• However, while checking the engine, follow these
  recommendations
• Keep 24 inches (60 cm) between your device and
  the engine is when it is running.
• Close contact with the running motor may
  temporarily affect how it your device functions.

15
Myth or Fact?

• I won't be able to use my cell phone.

• Myth.
• EMI from the cell phone may affect the ICD, CRT-D
  or pacemaker.
• It can be safely used if
• Keep 6 inches from device.
• Keep 12 inches from device if transmits more than
  3 watts.
• Hold the cellular phone on the opposite side of
  your body from the implanted device.
• These recommendations apply whether or not the
  phone is ON.

16
Myth or Fact?

• I can't have sex anymore because my elevated
  heart rate will make my device deliver a shock.

• Myth.
• When you have sex, your heart rate increase is
  similar to what would happen during exercise.
• Your doctor can program your ICD system settings
  so that you can comfortably engage in a broad
  range of physical activities.

17
Myth or Fact?

• I can use electric blankets and microwave ovens.

• Fact.
• All three are safe and should not affect the
  function of your implanted device.
• Also included on this list are radios, hair
  dryers, personal computers, printers, fax
  machines, and most other household appliances and
  office equipment.

18
Myth or Fact?

• My pacemaker can deliver a shock for a fast heart
  rate.

• Myth.
• Pacemakers deliver low energy pacing pulses to
  help a slow heart rate become more normal.
• Pacemakers do not deliver shock therapy.

19
Myth or Fact?

• I can still operate a lawn mower even though I
  have an implanted device.

• Fact.
• Lawn mowers and other gas-powered tools such as
  chainsaws and snow blowers can be used.
• Keep these tools 12 inches (30 cm) from your
  device when running.
• Close contact with the running motor in these
  tools may temporarily affect how your device
  functions.
• The distance required to drive or ride the mower
  is safe.

20
Myth or Fact?

• If I have an implanted device, I should refrain
  from exercise like running and biking.

• Myth.
• Having an implanted device should not prevent you
  from running or biking.
• In fact, maintaining a moderate exercise program
  will help keep you healthy.
• Talk to your doctor about creating an exercise
  plan that's right for you.

21
Questions?

• What questions do you have about life with an
  implanted device?

22
Important Safety Information

• Cardiac Resynchronization Therapy Devices
• Cardiac resynchronization therapy pacemakers
  (CRT-P) and defibrillators (CRT-D) are used to
  treat heart failure patients who have symptoms
  despite the best available drug therapy. These
  patients also have an electrical condition in
  which the lower chambers of the heart contract in
  an uncoordinated way and a mechanical condition
  in which the heart pumps less blood than normal.
  CRT-Ps and CRT-Ds are not for everyone including
  people with separate implantable
  cardioverter-defibrillators (CRT-P only) or
  certain steroid allergies. Procedure risks
  include infection, tissue damage, and kidney
  failure. In some cases, the device may be unable
  to respond to your heart rhythm (CRT-P only) or
  may be unable to respond to irregular heartbeats
  or may deliver inappropriate shocks (CRT-D only).
  
• Implantable Cardioverter Defibrillators
• An implantable cardioverter defibrillator (ICD)
  can protect you from the effects of sudden
  cardiac arrest by reviving your heart rhythm. An
  ICD is not for everyone, including people with
  certain steroid allergies. Procedure risks
  include infection and tissue damage. In some
  cases, the device may not respond to irregular
  heartbeats or may deliver inappropriate shocks.
• Pacemakers
• A pacemaker system can monitor and treat your
  heart rhythm by delivering electrical energy to
  pace your heart when it senses a slow rhythm. A
  pacemaker is not for everyone, including patients
  with certain steroid allergies. Patients who have
  additional medical conditions that may not allow
  the pacemaker to function appropriately should
  not receive a device. Procedure risks include
  infection, tissue damage and kidney failure. In
  some cases, the device may not respond to your
  heart rhythm.
• For All Devices
• In rare cases severe complications or device
  failures can occur. Electrical or magnetic fields
  can affect the device. Only your doctor knows
  what is right for you. These devices are
  available by prescription only. Individual
  results may vary.
• Device Quality and Reliability
• It is Boston Scientifics intent to provide
  implantable devices of high quality and
  reliability. However, these devices may exhibit
  malfunctions that may result in lost or
  compromised ability to deliver therapy. Refer to
  Boston Scientifics CRM product performance
  report on www.bostonscientific.com for more
  information about device performance, including
  the types and rates of malfunctions that these
  devices have experienced historically. While
  historical data may not be predictive of future
  device performance, such data can provide
  important context for understanding the overall
  reliability of these types of products. Also, it
  is important that you talk with your doctor about
  the risks and benefits associated with the
  implantation of a device.
• (Rev. B)

23
Thank you!

• This presentation was sponsored byBoston
  ScientificCardiac Rhythm Management
• We work to improve the quality of life for
  cardiac patients and those who care for them.