If you have suffered from a heart condition such as sudden cardiac arrest or congestive heart failure, your physician might recommend placement of an implantable cardioverter defibrillator. The device, inserted into the chest or abdomen, uses electrical pulses or shocks to help control life-threatening, irregular heartbeats, preventing cardiac arrest. Because the ICD has programmed parameters that prompt it to deliver a shock if your heart rate goes below or above the predetermined range, caution is advised when using exercise equipment.
Before Using Exercise Equipment Alone
After having an ICD placed, your physician will likely recommend completion of a cardiac rehabilitation program. During the program, a medical worker or exercise physiologist will instruct you to use various exercise equipment such as a treadmill or stationary bicycle while closely monitoring your heart rate and ensuring that it remains within a safe range. This practice will provide you the knowledge of the type and intensity of exercise allowable to reap cardiovascular benefits while still avoiding a discharged shock from your ICD.
Benefits of Exercising in ICD Patients
Although some patients will avoid exercising for fear of receiving an ICD shock, aerobic exercise is safe and feasible. A 2006 study by the American Heart Association demonstrated that activities such as walking on the treadmill improved cardiorespiratory fitness and heart rate variability, without delivering ICD shocks to any participants. It could even be argued that the habitually sedentary are at greater risk of receiving a shock when undertaking moderate exertion than those who are regularly active. Presumably, this happens because sedentary bodies are not conditioned for exercise, thus increasing the chance of quicker heart rate elevation and ICD shock.
Associated Risks
Using exercise equipment with an ICD does carry risks. A 2010 study in the Journal of the American College of Cardiology explains that exercise increases heart rate and adrenergic tone. Exercise could cause irregular heart beats that will prompt your ICD to deliver a shock to reset your heart rhythm. Patients with ICDs have also reported that using built-in heart rate monitors on exercise equipment have resulted in inaccurate readings. A falsely low reading may lead you to believe that you can increase the intensity of exercise, even though your heart rate may be close to threshold already.
Additional Considerations
While use of aerobic exercise equipment in patients with ICDs has been examined, little available research is available related to the use of anaerobic equipment such as weight machines. If you have an ICD, consult your doctor before beginning any type of exercise program. Depending on your unique condition, the physician may recommend adherence to a certain regimen or even prohibit use of exercise equipment altogether. Wearing a special heart rate monitor may also be necessary to ensure that your heart rate is within a safe range during exertion.
References
- U.S. Department of Health and Human Services: Implantable Cardioverter Defibrillator
- American Heart Association: Exercise After an ICD Improves Cardiorespiratory Fitness and Heart Rate Variability; Cynthia Dougherty, et al.; Fall 2006
- American Heart Association: Driving and exercise in patients with ICDs; Lisa Nainggolan; November 2003
- Journal of the American College of Cardiology; Exercise Training and Implantable Cardioverter Defibrillator Shocks in Patients with Heart Failure: Results from HF-Action; Jonathan P. Piccini, et al.; March 2010
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