Movement Guidance Following a Cardiac Device

Quick Take

If you’ve had a pacemaker, ICD, S-ICD, or CRT device fitted, careful movement and progressive return to activity are key for safe recovery. In the first 4–6 weeks avoid heavy lifting and overhead arm use on the implant side, keep your wound protected, and gradually build walking and light activity. Long term, most people can enjoy moderate exercise (Borg RPE 9–13) with only a few restrictions.

What Are Cardiac Devices?

ICD (Implantable Cardioverter Defibrillator): Detects and treats dangerously fast rhythms with pacing or a shock.

S-ICD (Subcutaneous ICD): Sits under the skin without leads into the heart; delivers shocks but does not pace the heart.

CRT (Cardiac Resynchronisation Therapy): Coordinates left and right ventricle contractions, sometimes combined with defibrillator function (CRT-D).

These devices reduce the risk of sudden cardiac arrest and help regulate rhythm, but require short-term movement precautions while the leads and wound heal.

Early Movement Guidance (First 4–6 Weeks)

Arm movements:

For ICD/CRT with leads: avoid lifting your elbow above shoulder height on the implant side. Gentle mobility below shoulder height is encouraged.

For S-ICD: less restriction, but still avoid strong pressure or heavy stretching near the wound until healed.

Wound care: Keep the site clean and dry. Avoid tight clothing that rubs on the wound. Healing usually takes 6 weeks.

Lifting: Avoid heavy lifting (e.g., shopping bags, weights). Stick to light loads only.

Walking: Daily walking is safe and encouraged. Start with 5–10 minutes, progress gradually.

Driving: Restrictions vary (longer for ICDs, especially if implanted after cardiac arrest). Always check DVLA guidance and your team’s advice.

"A little progress each day adds up to big results." – Satya Nani

Long-Term Movement & Exercise

Aerobic exercise: Aim for 150 minutes per week of light-to-moderate activity (e.g., brisk walking, cycling, swimming once healed). Borg RPE 9–13 is a safe target.

Strength training: Safe after 6 weeks. Start light, progress slowly. Avoid breath-holding (Valsalva).

Swimming: Safe once wounds are fully healed. Avoid swimming alone until confidence is regained.

Sports: Walking, golf, bowls, tai chi, yoga, and cycling are suitable. Avoid contact sports, HIIT, or high-impact training due to risk of trauma or inappropriate shocks

Warm-up and cool-down: Extend both phases to lower arrhythmia risk

Safety Considerations

Shock events: If you get 1–2 shocks but feel well, contact your device clinic for review. If multiple shocks or you feel unwell, call 999

Medical ID: Carry your device ID card at all times.

Travel & lifestyle:

Airports: walk steadily through scanners, show your device card, and ask for hand search if needed.

Equipment: most appliances are safe, but avoid strong magnets, welding, or leaning over car alternators

ICD Patient Info

Phones: keep at least 6 inches from the device; use the opposite ear.

Sexual activity: Safe to resume; an possible shocks will not harm your partner

Emotional Wellbeing

It is common to feel anxious about shocks, device awareness, or exercise. Cardiac rehabilitation sessions, counselling, and patient support groups can help restore confidence.

"Sometimes the bravest and most important thing you can do is just show up." – Brené Brown

SMART Challenges

Short-term (first 6 weeks):

Take a daily 10–15 minute walk, keeping effort at RPE 9–11 (“very light to fairly light”), keeping your implant-side arm below shoulder level.

Long-term (by 12 weeks post-implant, once cleared):

Achieve 150 minutes/week of moderate aerobic activity and add 2 weekly strength sessions at RPE 12–14.

References & Further Reading

Arrhythmia Alliance: ICD / CRT / S-ICD Booklet

Heart Rhythm Charity: ICD Patient Information

Boston Scientific: S-ICD Patient Brochure

Imperial Cardiovascular Health Service: Physical Activity & Exercise Advice for Patients with ICD or CRT-D

British Heart Foundation – www.bhf.org.uk

Related Posts

Walking: A Heart-Healthy Guide for People with Cardiac Conditions

Cycling: A Heart-Healthy Guide for People with Cardiac Conditions

Tai Chi , Yoga & Pilates: A Heart-Healthy Guide for People with Cardiac Conditions

If you need further guidance, have any specific questions or would like a personalised plan, please get in touch

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This blog post was written by Jamie Pickett, Clinical Exercise Physiologist, with AI assistance.