Pacemakers: 15 everyday things you can and cannot do with one

Pacemakers are small electrical devices that regulate electrical activity in the heart and are used to treat some abnormal heart rhythms (arrhythmias), such as atrial fibrillation (AF).

They can give you a new lease of life and allow you to resume daily activities, such as exercise, which you may have stopped due to debilitating and worrying symptoms.

Pacemakers detect if the heart has slowed down or missed a beat and then send an electrical impulse to stimulate the heart, restoring its normal rate of 60 to 100 beats per minute (bpm). This is known as back-up pacing.

They can also be programmed to take over the heartbeat entirely, meaning the pacemaker controls the heart rhythm all the time. This is known as being constantly paced.

Is there 1 type of pacemaker?

No, there are different types of pacemakers including:

• single chamber
• dual chamber
• biventricular
• leadless.

They are all roughly the size and weight of a large coin or a small box of matches, and most are implanted in the upper left side of the chest.

And some people living with heart failure may be offered a specific type of treatment called a cardiac resynchronisation therapy (CRT) device if their heart chambers contract in an uncoordinated way.

These devices can have a pacemaker function to help manage the heart's rhythm.

You should speak to your doctor about what pacing device is best for you.

Modern pacemakers are very robust and are designed to let people return to a normal, active life.

But you may have concerns about what you can and cannot do with a pacemaker and what happens if the pacemaker stops working.

Below are answers to 15 key questions.

1. Can I use an induction hob if I have a pacemaker?

Yes, but like anything that produces a strong electromagnetic field, an induction hob can interfere with the ability of your pacemaker to detect the electrical activity of your heart.

So if you’re using one, keep a distance of at least 60cm (2ft) between the stovetop and your pacemaker.

Most people should be able to use this type of hob if they follow this recommendation, but if you are buying a new appliance, it may be worth going for a different type of cooker.

2. Can I use home appliances that contain magnets?

Yes, but try to keep them 15cm (6ins) away from your pacemaker.

The following home appliances should be use at the recommended distance:

• handheld hairdryers
• older shavers with an electrical cord
• large stereo speakers
• electric toothbrushes and base chargers of ultrasonic toothbrushes
• electric blankets
• heated clothing.

Hand-held low-powered tools, such as cordless screwdrivers, are generally safe to use. Keep them at the recommended 15cm (6ins) distance from your pacemaker and avoid leaning your chest directly against them.

Microwaves are safe to use if you have a pacemaker.

When buying clothes, avoid any items with magnetic fasteners that will sit close to your pacemaker.

And try not to linger near or lean on the anti-theft pedestals for security at shop entrances as they can interfere with your pacemaker.

Remember that, often, moving away from the object with the electromagnetic field will allow your pacemaker to reset itself.

If in doubt about whether a certain appliance is safe to use, you can look up the manufacturer's website and check that specific device/model for electric magnetic interference (EMI) and advice they give on various household items.

You can also ask your clinician or pacing clinic for advice.

3. Can I use a TENS machine with a pacemaker?

No. If you have a pacemaker, there are some devices that you should avoid using completely, including:

• TENS machines (used for pain relief)
• electronic body fat scales
• magnetic mattress pads or pillows
• abdominal stimulators (used for building muscle)
• welding equipment (with currents above 130amps).

If in doubt, check the written information given to you when your pacemaker was inserted.

You can also check the manufacturer’s safety information for individual appliances and ask your pacing clinic if you have questions.

4. Can I use a mobile phone or headphones when I have a pacemaker?

Mobile phones and headphones contain magnets, as well as other elements that also produce electromagnetic fields.

They are generally safe to use with a pacemaker, but you should keep phones or headphones 15cm (6ins) away from your pacemaker and avoid placing them directly over the device or leaving them nearby when you sleep.

Try to use your phone on the opposite side of your body to your pacemaker and do not put it, or your headphones, in a chest pocket that is on the same side as your pacemaker.

Do not drape your headphones around your neck and do not allow someone wearing headphones to rest their head on your chest.

5. Can I wear a smartwatch if I have a pacemaker?

It is not currently clear whether it is safe to use newer devices like smartwatches when you have a pacemaker.

If you choose to wear a smartwatch keep it 15cm (6ins) away from the side of your chest where the device was implanted at all times.

It is a good idea to wear your watch on the wrist opposite to the side where your pacemaker was implanted.

And avoid wearing it to bed if you tend to sleep with your hands near your chest.

When charging the smartwatch, keep the magnetic charger at least 30cm (12ins) away from your pacemaker.

It is also worth checking your watch’s features. If it has ‘body composition’ or bioimpedance features, consult your cardiologist before using it.

6. Can I have an MRI scan with a pacemaker?

Yes, as most modern pacemakers are MRI compatible.

But you should always tell healthcare staff you have a pacemaker, and show them your pacemaker identity card, before any test or procedure.

It is also worth always telling doctors and dentists about your pacemaker, as some specialised equipment can interfere with the device.

7. Can you use a defibrillator on someone with a pacemaker?

Yes, if someone with a pacemaker has a cardiac arrest, it’s safe to use a defibrillator to get their heart started again.

Most pacemakers are implanted in the upper left side of the chest.

As compressions during cardiac pulmonary resuscitation (CPR) are done over the centre of the chest, they should not affect the pacemaker.

When it comes to using an automated external defibrillator (AED), the pads are usually placed on the upper right side of the chest and on the side of the rib cage under the left arm, so are not close to the pacemaker.

Remember, that if you need to give CPR and use a defibrillator on someone with a pacemaker, the priority is getting help quickly.

If you have had a cardiac arrest, your pacemaker settings will be checked after CPR or defibrillation.

8. Can I turn the pacemaker monitor off to save energy?

No, you must keep the remote monitor switched on, but be reassured that they do not use much energy.

These at-home devices send information from your pacemaker to your cardiac centre so your specialist can check how the device is working, its battery levels and any heart rhythm changes.

If you are worried about the rising cost of energy bills and the cost of living crisis, there may be financial help available.

9. Can I drive with a pacemaker?

Yes, but you must tell the DVLA (Driver’s Vehicle Licensing Agency) that you have had a pacemaker fitted.

It’s also important to tell your insurance company that you are driving with a heart condition.

10. Can I drive an electric car with a pacemaker?

Yes, you can. The magnetic field strength inside an electric car remains well within safety standards and does not interfere with a pacemaker’s programming or function.

But it is recommended to keep a 30cm (12ins) distance between your pacemaker and the charging station or cable while it is in use.

Also avoid leaning directly against the charging cable or draping it over your shoulder near the pacemaker site.

11. Can I fly with a pacemaker?

Yes, it is safe to fly with a pacemaker and walk through scanners at airport security.

But remember that the device might set off the scanner alarm, so always carry your pacemaker identity card to show airport staff you have the device implanted.

If you have concerns about travelling speak to your doctor.

12. Can I exercise with a pacemaker?

Yes, but for the first 6 weeks after having a pacemaker fitted, avoid lifting your arms above your head or doing heavy housework, gardening, golfing, lifting heavy weights or DIY.

In the long term, a pacemaker should make physical activity much easier.

Just follow your doctor’s advice on what kinds of activity are appropriate.

13. Can I have sex with a pacemaker?

It’s fine to resume sexual activity after your initial recovery. If you feel worried, there are ways to reduce your anxiety.

14. Can my pacemaker suddenly stop working?

Your pacemaker will not run out without warning. The device is highly reliable, with batteries lasting several years.

You will be offered routine checks at your clinic or via remote home monitoring, to allow technicians to track the battery voltage.

The device also triggers a specific alert called an Elective Replacement Indicator (ERI) when it has about 3 to 6 months of life left, giving you plenty of time to schedule a battery swap, also known as a ‘box change’ (generator replacement).

This is usually simpler than the first pacemaker procedure because the wires (leads) stay in place, and only the metal box containing the battery is swapped for a new one.

15. What happens to a pacemaker at the end of my life?

A pacemaker regulates your heart rhythm, but it does not stop the natural dying process from other causes like a heart attack, stroke, infection or organ failure.

If someone is dying naturally, the heart muscle eventually becomes too weak to respond to the pacemaker's electrical signals.

The pacemaker will keep sending pulses, but the heart will naturally stop beating.

Pacemakers do not need to be switched off when someone is dying. They may be deactivated, and this can be discussed with your doctor.

But they should be removed before cremation as the heat could cause the device to explode.

Take-home message

Modern pacemakers are incredibly reliable devices which can help you live a normal, active life.

If you are unsure about using a particular appliance with your pacemaker then consult the manufacturer’s safety advice or ask your pacing clinic.

If you experience any new symptoms that you feel may be related to your pacemaker, such as dizziness or palpitations, talk to your GP or pacing clinic so your device can be checked.

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