15 Things You Can't Do With a Pacemaker

There are precautions to take when living with a pacemaker, though next-generation models often present fewer risks than older pacemakers. Exposures ranging from the magnets in a wearable device, to welding equipment or certain motor types, may interfere with pacemaker function.

That's because a pacemaker is a small electronic device that is implanted under the skin to help regulate the heart rhythm, usually due to bradycardia (slow heart rate) or heart failure. Any interference in the environment, even cellphone use, can lead to complications.

1. Avoid Strenuous Activity After Surgery

Pacemaker implantation is a minimally invasive surgery, with some minor variations in technique depending on the device type. 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, like running 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.

You may be given antibiotics and blood thinners before your procedure. During the initial period after placement, 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.

2. Do Not Get Checked With Airport Hand Scanners

Your pacemaker may set off the walk-through metal detector commonly used in airport security. 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. 

You can carry a medical identification card and ask for a separate screening. Keep in mind, though, that the hand-held scanner the security agent may use contains a magnet that may interfere with your pacemaker when it is brought near. 

3. Avoid Electronic Cigarette Use

There have been isolated reports of an electronic cigarette device affecting an implantable pacemaker. A 2020 report detailed how magnetic components in a device kept in the left shirt pocket, over the pacemaker site, caused a beeping tone due to pacemaker disruption.

The role of magnets was explained to the user and he was advised to keep the e-device away from the pacemaker. Experts advise that you avoid e-cigarette use with a pacemaker.

4. Do Not Get Too Close to 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. To minimize this risk, it's important to keep motorized items at least six inches away from the body, especially when the item is powered on.

5. Avoid Welding and Construction Equipment

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

6. Stay Clear of 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 6 inches away from where the device is located 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.

7. Minimize Exposure to 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.

8. Keep Your Cellphone Away

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.

As long as the phone is kept 6 inches or more away from the pacemaker, there should not be a problem.

9. Do Not Have Headphones Nearby

Most headphones contain magnets that can interfere with pacemakers. This includes earbud and clip-on headphones.

If you use headphones, keep them at least 6 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.

10. Avoid 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.

11. Pass on Using 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 use should be avoided because the pulse generator in the device can briefly interfere with your pacemaker.

12. Do Not Undergo Radiation Unprotected

Radiation therapy used to treat cancer can affect your pacemaker. If you need radiation therapy, your pacemaker will need to be specially shielded to protect it from the radiation field.

It's not entirely clear how often complications can arise due to radiation treatments, but a review of 32 studies on implanted cardiac devices (including pacemakers) found impacts occurred in a range of between 4% and 20% of all cases.

The radiation dose didn't necessarily involve a greater risk in all cases, but the complexity of the device technology may be a factor that increases the potential for disruption.

13. Avoid Electrocautery

Electrocautery is a procedure used during surgery to control bleeding. It can be used during many types of surgeries, including treatment for endometriosis or acute pancreatitis.

Electrocautery relies on a small probe that delivers current and also can be used to remove tissue, like a tumor or other skin lesion. While it is generally regarded as safe in people with pacemakers, there have been some reports of it interfering with pacemaker function.

14. Skip 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.

15. Check if Your Pacemaker Is MRI-Safe

Magnetic resonance imaging, or MRI, uses strong magnetic fields and pulses of radiofrequency to generate detailed images of your inner body. MRI-safe pacemakers were approved by the FDA in 2011 and have since become the standard pacemaker in many parts of the world.

Newer pacemakers are often called MRI compatible or MRI conditional, and they're safe for an MRI procedure after a six-week wait from implantation. However, MRI machines can heat up the pacemaker leads (there are now devices with no leads, too) and they can affect programming in some devices.

For those with an older pacemaker, there are several steps used to make the MRI safer. Talk with your cardiologist before the procedure to ensure safety and be sure a pacemaker programming device is on hand during MRI scanning.

Can I Return to My Daily Activities With a Pacemaker?

Despite what may seem like 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 play sports, be sure to do so only on the advice of your healthcare provider. Carry a card with you that indicates you use a pacemaker.

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.