Tuesday, September 28, 2010

News You Can Use: Sex and Your Defibrillator

Have a defibrillator and feel like getting frisky? For the first time that I can recall, there's a very helpful article published in Circulation addresses the concerns of implantable cardiac defibrillator(ICD) patients and sexual activity. There's all kinds of helpful tidbits, like this one:
A study of 1774 patients who had experienced an acute myocardial infarction showed that sexual activity was a likely contributor in fewer than 1% of cases. In fact, regular physical exertion, such as that associated with sexual activity, was associated with a decreased risk of cardiac events in patients!
Now that's helpful!

Recall that defibrillators are designed to detect rapid, potentially life-threatening arrhythmias. Most of the time, sexual activity does not lead to heart rates at a level that ICD's would consider elevated during intercourse. (This, of course is patient-specific). While your doctor can tell you the rate cut-off at which your ICD might possibly fire, watching your heart rate rise with a monitor during those moments might be a bit of a, shall we say, turn-off..

My rule of thumb: if you have a defibrillator (ICD) and can walk up two flights of stairs without getting a shock, you'll probably be okay having sex. (Be sure to check with your doctor, these are just my ballpark recommendations. Also, this rule of thumb may not apply to those involved in extramarital affairs. As we've heard, heart rates accelerate much more when a naughty, clandestine element is involved). But please be careful: if one flight of stairs makes you too exhausted or short of breath, you'd better check with your doctor first.

Now, what about the partner? What happens if the defibrillator fires and you're at the peak of passion?

First, you might give out a "yelp." That's because the shock often causes the diaphragm and vocal cords to contract. It happens very suddenly, and your partner might not mind this part, but the kids down the hall... well, that's another thing.

Second, ICD shocks won't hurt you partner. On the contrary, it might be... well, let's put it this way... interesting!

Third, if repetetive shocks occur as a result of your activities, well, sorry my friend, you've had enough and probably should head to the ER. Realize this is an infrequent event, but any time there are back-to-back shocks it means one of several things: (1) you're having a lot of rhythm problems, (2) your device might need to be reprogrammed to avoid shocks at this level of exertion, or (3) (least likely) you might have a faulty lead that needs repair.

Common sense should dictate each person's individual approach, but for the most part, ICD's needn't hold you back!

-Wes

Reference: Lauren D. Vazquez, PhD; Samuel F. Sears, PhD; Julie B. Shea, MS, RNCS, FHRS; Paul M. Vazquez, DO. "Sexual Health for Patients With an Implantable Cardioverter Defibrillator." Circulation. 2010;122: e465-e467.

5 comments:

Steve Parker, M.D. said...

You remind me of those Cialis TV commercials: "Ask your doctor if you're healthy enough for sexual activity."

In 20 years, none of my patients have asked me that.

DrV said...

Find a way for the partner to control the yelp and then you'll be onto something. We could see recreational use of defibrillators.

Anonymous said...

Well, the conventional wisdom out there about an ICD shock during sex is that your partner might "experience a tingle" if this were to happen. But speaking from personal experience, the one time my ICD delivered a shock during sex (some 4 years after the ICD implant) my wife felt much more than a "tingle", but instead got a jolt which was apparently similar in intensity to what I feel when I get shocked. It was apparently conducted through our lips while kissing shortly after our climax, and she characterized it as a "jolt to the head".

My doctor determined that the shock was appropriate when the ICD was later interrogated. I had experienced a number of appropriate shocks in various situations previously, but only this one time associated with sex. Now by wife is terrified by the thought of a repeat "shocking" performance in bed, and cannot bring herself to have sex with me since then. Perhaps our experience was a rare case... but apparently YMMV considerably with regards to the "tingle" experienced by a partner.

Anonymous said...

I loved your article and sense of humor. My questions were answered and I appreciate your help. I also enjoyed reading the comments of others with this issue.
We had the experience "at a moment of passion." We got to the emergency around 2 AM. The nurse assumed my husband was sleeping when his ICD fired, and we did not contradict her assumption. But when the doctor asked point blank what he was doing when it fired, he told him it was a moment of passion. We were there for several hours and could just picture the ER staff having a good laugh about the 68 year old man and his 60 year old wife having sex at 1:30 in the morning. There have been no problems since.

Anonymous said...

Well, your comment ("ICD shocks won't hurt your partner. On the contrary, it might be... well, let's put it this way... interesting!") doesn't seem to be true in my case. I got shocked during sex with my wife (just afterwards, actually) and she definitely felt the jolt. She describes herself as being "traumatized" by the event... to the extent that she has refused sex for the 3+ years since then. I can't know exactly what she did or didn't feel, but what I felt was probably not as strong as other shocks that I had received before that time. The conventional wisdom seems to be that a partner won't feel a shock... but I guess YMMV?