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 FAQ-Living with your implanted device

2. 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 Patients like you have asked about: FAQ-Living with 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 FAQ-Living with your implanted device

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. FAQ-Living with your implanted device

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. FAQ-Living with your implanted device

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 use—not 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. FAQ-Living with your implanted device

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. FAQ-Living with your implanted device

8. 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 With all the new security at airports, I'm thinking about my pacemaker and how I can make sure everything goes smoothly. Airport Security Attention Security Personnel FAQ-Living with your implanted device

9. 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. Traveling FAQ-Living with your implanted device

10. 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 Device replacement FAQ-Living with your implanted device

11. Cardiac Device Myths and FactsLet’s see what you know about your implanted device FAQ-Living with your implanted device

12. My device is a cure-all for all my heart problems. Myth. No device is a cure-all for any heart problem. Follow your doctor’s orders for adopting a healthy lifestyle. Being compliant with your medications. Myth or Fact? FAQ-Living with your implanted device

13. 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. Myth or Fact? FAQ-Living with your implanted device

14. 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. Myth or Fact? FAQ-Living with your implanted device

15. 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. Myth or Fact? FAQ-Living with your implanted device

16. 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. Myth or Fact? FAQ-Living with your implanted device

17. 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. Myth or Fact? FAQ-Living with your implanted device

18. 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. Myth or Fact? FAQ-Living with your implanted device

19. 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. Myth or Fact? FAQ-Living with your implanted device

20. 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. Myth or Fact? FAQ-Living with your implanted device

21. Questions? What questions do you have about life with an implanted device? FAQ-Living with your 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 Scientific’s 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 Scientific’s 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) FAQ-Living with your implanted device

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. FAQ-Living with your implanted device