Resources for Families

Children with pacemakers and ICDs should be able to do almost all of the same activities everyone else in their age group is participating in. However, when involved in a physical, recreational, or sporting activity, a child with a pacemaker or ICD should avoid receiving a blow to the skin over the pacemaker. A blow to the chest or abdomen near the pacemaker/ICD can affect its functioning. Contact sports are usually not recommended for children with pacemakers/ICDs for this reason. If your child does receive a blow to that area, contact your child's physician. In addition, many patients with ICDs may be restricted from engaging in certain physical activities or playing competitive sports. Consult your child's physician for specific activity restrictions. For patients with pacemakers or ICDs implanted in the upper chest, we usually recommend restrictions for weight lifting. Please discuss these restrictions with your physician.

Always consult your child's physician when he/she feels ill after an activity, or when you have questions about beginning a new activity.

With advances in technology, implanted pacemakers today generally last five to eight years, depending upon the type of heart condition, and, in most cases, allow a child to lead a normal life. In addition, advances in pacemaker circuitry have reduced the interference risk from certain machinery, such as microwaves, which in the past may have altered or otherwise affected the pacemaker. Even so, certain precautions must be taken into consideration when a child has a pacemaker.

Although your child's pacemaker/ICD is built to last several years, always check the pacemaker regularly to ensure that it is working properly. The proper method for checking the accuracy of your pacemaker includes the following:

• Take your child's pulse regularly to make sure the pacemaker/ICD is keeping your child's pulse at the targeted rate.
• Participate in a telephonic or web-based check-up for your child's pacemaker/ICD on a periodic basis. Your child's physician will provide special instructions. See below.
• See your child's physician regularly for check-ups. We recommend in-office follow up visits every 4-6 months, depending on whether you have a pacemaker or ICD.
• Report any unusual symptoms or symptoms similar to those your child had prior to the pacemaker insertion to your child's physician immediately.

Always consult your child's physician for more information, if needed.

You will be given a small transmitter take home that will allow you to send in a pacemaker/ICD check via the telephone. Depending on the type of pacemaker/ICD you have, the transmission will either go directly to a computer in our cardiology department, or to a secure website. You will be given the phone number to call and specific instructions for how to perform these telephone checks. We recommend telephone checks every 1-3 months, as directed by your physician.

Your child should wear a medical identification bracelet or necklace to let others know about the pacemaker or ICD in case of emergency. When he/she is old enough to have a wallet, it is a good idea to carry an ID card that states he/she has a pacemaker or ICD.

In the past, people with pacemakers risked interference with the proper functioning of their pacemakers due to coming in close proximity with common electrical appliances. However, with improvements in pacemaker technology, some of these issues are no longer of major concern.
According to The American Heart Association and pacemaker manufacturers, the following items have not been shown to alter the function of today's pacemakers:

• Microwave ovens
• Kitchen appliances such as blenders, toaster ovens, and electric knives
• Televisions (including the remote control), FM and AM radios, and stereos
• TV and radio transmitters
• Ham radios and CB radios
• Electric blankets and heating pads
• Electric shavers, hair dryers, curling irons, and other personal care appliances
• Gardening machinery, such as electric trimmers
• Garage door openers
• Metal detectors
• Computers
• Copying and fax machines
• Properly grounded shop tools (except power generators or arc welding equipment)

Cellular phones can affect the functioning of pacemakers and ICDs. Most pacemakers made today have a filter that blocks out the radio signals emitted from cellular phones; however, this is still unreliable. Studies are being done to investigate this further. For this reason, cell phones should be kept at least 6 inches from the device and not carried in the shirt pocket on the side where the pacemaker is implanted.
Make sure your child uses caution when going through security detectors at airports and government buildings such as courthouses. Pacemakers currently being manufactured should not be affected by these security devices, as long as the child moves through and away from the detector at a normal speed. Check with your child's physician about the safety of going through such detectors with your child's particular pacemaker. The metal in the pacemaker may activate a security alarm, however. Be prepared to show an identification card for the pacemaker or a medical identification bracelet in order to pass through security checkpoints.
The following situations may cause interference with pacemakers and/or ICDs. (Some of the activities mentioned are not appropriate until a child nears adulthood, but may affect older teenagers.) Discuss the following in detail with your child's physician:

• Avoid working with, holding, or carrying magnets near the pacemaker/ICD.
• Avoid magnetic resonance imaging (MRI) machines or other large magnetic fields, since the pacemaker's performance can be affected. Metal objects are not permitted near MRI machines.
• Abstain from diathermy (the use of heat in physical therapy to treat muscles).
• Turn off large motors, such as cars or boats, when working on them, as they may temporarily "confuse" the pacemaker's or ICD. Do not use chain saws, because of the close contact with the motor components.
• Avoid certain high-voltage machinery, such as electric arc welders, high-tension wires, radar installations, smelting furnaces, electric steel furnaces, and other high-current industrial equipment. Avoid working in restricted spaces near radio or television transmitting towers and antennas.
• Avoid close contact with large stereo speakers such as in auditoriums and concerts.
• If your child is having a surgical procedure performed by a surgeon or dentist, tell the surgeon or dentist that your child has a pacemaker so that electrocautery will be used with caution to control bleeding (the electrocautery device can change the pacemaker settings).

Certain medical procedures may occasionally affect the function of the pacemaker, but might be performed successfully with some adjustments to the pacemaker settings. These procedures include the following:

• Extracorporeal shock-wave lithotripsy (ESWL) - a procedure that dissolves kidney stones.
• Radiofrequency ablation - a procedure that uses radio waves to control irregular heart rhythms.
• Transcutaneous electrical nerve stimulation (TENS) - a device used to relieve acute or chronic pain.
• Therapeutic radiation treatments for cancer

Consult your child's physician before your child undergoes these procedures.
Your child may also have to take antibiotic medication before any medically-invasive procedure to prevent infections that may affect the pacemaker or your child's heart.
Always consult your child's physician if you have any questions concerning the use of certain equipment near your child's pacemaker.