14 Things You Can't Do With a Pacemaker

A pacemaker is a small electronic device that is implanted under the skin to help regulate the heart rhythm. Most pacemakers are implanted to treat symptoms resulting from bradycardia (slow heart rate) caused by sick sinus syndrome or heart block.

Having a pacemaker is supposed to eliminate or prevent problems, not cause them. That's generally the case, but there are things to avoid with a pacemaker once you begin living with one.

This article presents a few simple precautions to consider as you follow your healthcare provider's guidance and a routine schedule for periodic follow-up care.

After Pacemaker Implantation

Pacemaker implantation is a minimally invasive surgery. The typical recovery period is not lengthy or difficult. You may experience pain at the incision site for a few days.

Your healthcare provider may ask you to restrict vigorous activity or lifting heavy objects for a week or two. The incision site is usually completely healed after two or three weeks, and you should have no further restrictions.

During this initial period, you should watch for signs of bleeding or infection, such as:

• Swelling
• Increased redness
• Worsening pain

Let your healthcare provider know if any of these signs occur. Fortunately, these complications are infrequent.

You will need to have your pacemaker checked periodically to make sure it is functioning normally and its battery has plenty of energy. Usually, these pacemaker checks can be done from home, wirelessly, using a special device your healthcare provider will give you for remote follow-up.

You will also be checked in your healthcare provider's office once or twice a year.

When the battery begins to run out, usually after five to 10 years, your healthcare provider will schedule an elective pacemaker replacement. This is a relatively simple procedure, carried out under local anesthesia, in which your old pacemaker generator is detached from its leads and thrown away.

A new generator is then attached and the incision is sewn up. Generally, the pacemaker leads never need to be replaced unless they develop a problem.

Precautions to Take with a Pacemaker

Contrary to popular belief, modern home appliances, including microwave ovens, do not interfere with pacemakers and should not cause any concern whatsoever. With certain other devices, there are only a few special precautions you will need to take to avoid problems like electromagnetic interference (EMI).

Airport Security Metal Detectors

Your pacemaker may set off the walk-through metal detector commonly used in airport security. The metal detector will not affect your pacemaker.

But a potential problem is the hand-held scanner the security agent may use on you after you set off the metal detector. The hand-held scanner contains a magnet that may interfere with your pacemaker when it is brought near.

Airport Security Full-Body Scanners

The full-body scanners at airports (the devices that make an image of your body) apparently will not affect your pacemaker, but there is surprisingly little objective evidence available on this issue. 

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging, or MRI, uses strong magnetic fields and pulses of radiofrequency to generate detailed images of your inner body. These mechanisms can cause the pacemaker to overheat, or interfere with its pacing.

MRI-safe pacemakers were approved by the FDA in 2011, and have since become the standard pacemaker in many parts of the world. For those with an older pacemaker who need an MRI, there are several protocols healthcare providers can take to minimize the risk of MRI interference, such as setting the pacemaker to safe-mode before the scan then reprogramming the pacemaker afterwards.

Diathermy

Diathermy is a type of therapy often used in physical therapy for pain relief. The therapy works by using high-frequency electromagnetic currents to generate heat within body tissues. This can effectively relieve pain, relax muscles, and expedite healing.

The electromagnetic fields produced via diathermy can interfere with the pacemaker's pulse generator, and can result in permanent damage. Diathermy is thus not recommended for most people with pacemakers.

Being Around Large Motors

Large motors, including those in cars and trucks, boats, aircraft, bulldozers, and cranes can temporarily interfere with your pacemaker's function. As such, you will need to make sure these motors are completely powered off when you are in close contact with or working on them.

Arc Welders and Construction

Welding and construction equipment often involve powerful electric and/or magnetic fields that can interfere with a pacemaker's ability to regulate heart rhythm, particularly when those items get close to the body.

If you have a pacemaker, stay at least two feet away from the following:

• Arc welders
• Electric drills (including cordless drills)
• Power saws, routers, and sanders
• Stud finders
• Laser levels
• Soldering irons and other light metalworking tools

Magnets

Magnetic fields in magnets can interfere with pulse generators in pacemakers. To avoid this risk, you will need to avoid prolonged contact with devices or machinery that contain magnets. If you have to be in contact with them, stay at least inches away at all times.

Items that contain magnets include:

• CPAP masks with magnetic clips used to secure the headgear
• Fitbit and Apple Watch
• Apple AirPods Pro charging case
• Microsoft Surface Pen

Take care to avoid carrying portable electronic devices with magnets in your shirt or jacket pocket, or resting them on your chest while lying down.

Anti-Theft Detectors

The walk-through anti-theft detectors in stores work by generating electromagnetic waves, which can momentarily interfere with the function of a pacemaker. However, as long as you walk through the detector normally, without stopping or pausing, you should not experience any problems. Just keep moving.

Cellular Telephones

Cellular phones, if held close to the pacemaker (which may happen if the phone is kept in a breast pocket) can potentially affect the function of a pacemaker. But as long as the phone is kept 6 inches or more away from the pacemaker there should not be a problem.

Headphones

Most headphones contain magnets that can interfere with pacemakers. This includes earbud and clip-on headphones. If you use headphones, keep them at least six inches away from your pacemaker, and don't store them in your jacket or shirt pocket, or drape them around your neck when not in use.

Lithotripsy

Extracorporeal shock-wave lithotripsy (ESWL) is a treatment that uses hydraulic shocks to dissolve gallstones or kidney stones. The treatment can also interfere with pacemaker functioning. If you must get ESWL, your pacemaker will need to be reprogrammed after the treatment. You may also need follow ups with your healthcare provider in the months after ESWL treatment to ensure your pacemaker is functioning properly.

TENS

Transcutaneous electrical nerve/muscle stimulators (TENS) are medical devices that transmit electrical currents through the skin to activate nerves, blocking or changing your perception of pain. TENS utilize a pulse generator that can briefly interfere with your pacemaker.

Radiation Therapy

The powerful radiation used in radiation therapy for cancer can damage the circuits of a pacemaker. If you need radiation therapy, your pacemaker will need to be specially shielded to protect it from the radiation field.

Electrocautery

Electrocautery is a procedure used during surgery to control bleeding. While it is generally regarded as safe in people with pacemakers, there have been some reports of it interfering with pacemaker functioning.

Can I Return to My Daily Activities With a Pacemaker?

Despite what may seem a long list of things to avoid with a pacemaker, there are minimal lifestyle changes you'll need to make in the day-to-day.

When you have a pacemaker, you are free to return to these activities:

• Doing yard work
• Bathing
• Having sex
• Driving a car, provided that you do not have any symptoms, such as fainting

If you want to return to exercise and playing sports, be sure to do so only on the advice of your healthcare provider.

There aren't really specific foods to avoid with a pacemaker itself. But if you have one it's because you have a heart condition, and that diagnosis means you need to adopt a heart-healthy diet. These diet changes focus on limiting red meat, many dairy products, and unhealthy fats, while adding whole grains, fresh fruits, and vegetables.

Summary

Pacemakers are sensitive to electric and magnetic fields found in numerous devices and machinery. If you have a pacemaker, you will need to avoid electromagnetic interference by keeping a safe distance from these items. Airport security scanners, MRIs, large motors in cars and boats, electric drills, and cell phones are just a few of them. Avoid placing small, magnetic or electric items in your jacket or shirt pocket, and make sure motorized machines are powered off before you get too close.