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If this happens, your doctor might have to replace the ICD. When you visit the doctor, ask whether the manufacturer has announced any problems with your device.

If you have survived sudden cardiac arrest, you may worry about whether it will happen again. After surgery to implant an ICD or fitting for a WCD, adjusting to the uncertainty of life with the device may cause fear, anxiety, and stress.

When your device sends a strong shock, it may startle or distress you or cause you pain. This can make some people stop doing the things they used to do.

After having sudden cardiac arrest or getting an ICD, some people report anxiety, depression, or other more serious emotional health concerns.

If you have survived cardiac arrest or are living with an ICD or WCD and experience anxiety or depression, tell your doctor about your concerns.

We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including defibrillators.

Learn about the current and future NHLBI efforts to improve health through research and scientific discovery. Learn about the following ways NHLBI continues to translate research and science into improved health for people who need defibrillators.

In support of our mission , we are committed to advancing research for people who can benefit from defibrillators in part through the following ways.

We lead or sponsor many studies relevant to defibrillator use. See whether you or someone you know is eligible to participate in our clinical trials.

Learn more about participating in a clinical trial. View all trials from ClinicalTrials. Defibrillators are devices that restore a normal heartbeat by sending an electric pulse or shock to the heart.

They are used to prevent or correct an arrhythmia, a heartbeat that is uneven or that is too slow or too fast. Different types of defibrillators work in different ways.

Automated external defibrillators AEDs , which are in many public spaces, were developed to save the lives of people experiencing sudden cardiac arrest.

Even untrained bystanders can use these devices in an emergency. Other defibrillators can prevent sudden death among people who have a high risk of a life-threatening arrhythmia.

They include implantable cardioverter defibrillators ICDs , which are surgically placed inside your body, and wearable cardioverter defibrillators WCDs , which rest on the body.

It can take time and effort to get used to living with a defibrillator, and it is important to be aware of possible risks and complications.

Explore this Health Topic to learn more about defibrillators, our role in research and clinical trials to improve health, and where to find more information.

It may also help to understand how the heart works. How do AEDs work? Image of an automated external defibrillator in use.

The image shows a typical setup using an automated external defibrillator AED. The AED has step-by-step instructions and voice prompts that enable an untrained bystander to use the machine correctly.

How do ICDs work? Comparison of an implantable cardioverter defibrillator and a pacemaker. The image compares an ICD with a pacemaker.

Figure A shows the location and general size of an ICD in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest.

Figure B shows the location and general size of a pacemaker in the upper chest. How do WCDs work? Who needs an AED?

Who needs an ICD? If you have the following conditions, you may be at risk for a life-threatening arrhythmia and your doctor may recommend an ICD: You survived sudden cardiac arrest.

You developed an arrhythmia during or after treatment for a heart attack. You have a genetic condition that causes arrhythmia. This includes having congenital heart disease or an inherited conduction disorder.

You have a neuromuscular disorder. For example, the progression of muscular dystrophy can damage the heart and cause unpredictable heart rhythms.

This can lead to unexplained fainting and a high risk of death. You have cardiac sarcoidosis. You have poor heart function following a procedure to improve blood flow.

Your doctor detected an arrhythmia during an electrocardiogram EKG or stress test. If this happened several times, you may be at increased risk.

Who needs a WCD? This might occur under these conditions: You are recovering from a heart attack. You are waiting for a heart transplant.

You are fighting an infection. You are removing or waiting to replace your ICD. Using an AED in an Emergency. When to use an AED. If you think someone may be in cardiac arrest, try the following steps: If you see a person faint or if you find a person already unconscious, first confirm that the person cannot respond.

The person may not move, or his or her movements may look like a seizure. You can shout at or gently shake the person to make sure he or she is not sleeping, but never shake an infant or young child.

Instead, you can gently pinch the child to try to wake him or her up. If the person is not breathing and has no pulse or has an irregular heartbeat, prepare to use the AED as soon as possible.

Where to find an AED. How to use an AED. When using an AED: Call or have someone else call If an electric pulse or shock is needed to restore a normal rhythm, the AED uses voice prompts to tell you when and how to give the shock, and electrodes deliver it.

Some AEDs can deliver more than one shock with increasing energy. The device may instruct you to start CPR again after delivering the shock.

Before and during surgery. Follow the instructions you receive. Your healthcare team may tell you to take these steps: Check the cut on your chest often and keep the area clean and dry.

Call your doctor if any swelling or bleeding occurs or if you develop a fever. Take over-the-counter pain medicines such as acetaminophen if you feel pain.

But talk to your doctor first; he or she may tell you to avoid taking ibuprofen or other kinds of pain medicines, for example.

Ask your doctor when you can resume taking medicines that you took before the surgery, how soon you can take a shower, and when you can return to work.

You will probably have to avoid driving for at least a week while you recover from your surgery. Your doctor may also ask you to avoid high-impact activities and heavy lifting for about a month.

Although they are rare, possible complications include: A bad reaction to the medicine used to make you relax or sleep during the surgery A collapsed lung A defibrillator wire puncturing the heart or a vessel Bleeding from the site where the device was placed Blood vessel, heart, or nerve damage Swelling, bruising, or infection at the area where the device was placed Venous thromboembolism Some ICD models have a lower risk of clots, puncture, and infection.

Living With to learn more about your recovery and life after you return home. Research for Your Health will explain how we are using current research and advancing research on defibrillators.

What to expect from electric shocks. The low-energy electrical shocks your device gives are not painful.

You may not notice them, or you may feel a fluttering in your chest. The high-energy shocks last only a fraction of a second, but they can be strong or painful.

They may feel like thumping or a kick in the chest, depending on their strength. Before a shock, you may feel arrhythmia symptoms. If you feel one or two strong shocks over a short period and the symptoms go away, it may be a sign that the device is working.

He or she will want to assess your condition and the device. During the adjustment period after your surgery, your device may deliver a shock when it is not needed.

A damaged wire or a very fast heart rate due to extreme physical activity may trigger unnecessary shocks. These shocks can also occur if you forget to take your medicines.

Some people also feel phantom shocks, even when the device does not detect an arrhythmia. Make sure your WCD is fitted properly. Return to normal daily activities.

An ICD usually will not limit you from taking part in sports and exercise, including strenuous activities.

You may need to avoid full-contact sports, such as football. Contact sports can damage your ICD or shake loose the wires in your heart.

Ask your doctor how much and what types of physical activity are safe for you. You probably will be able to resume your typical driving patterns after you recover from surgery.

However, if you received an ICD to prevent another sudden cardiac arrest or ventricular arrhythmia , it will probably be several months before your doctor says you are ready to drive again.

This is because of the risks of fainting or getting a shock from your device. Your doctor may also suggest driving restrictions based on the activity recorded by your device.

Receive routine follow-up care. At the follow-up visits, your doctor may also take these steps: Prescribe or adjust your medicines to decrease the number of irregular heartbeats you have.

Fewer irregular beats will mean fewer high-energy shocks that have to be sent to your heart. Check to make sure the device continues to work properly and that it has not shifted in your body or caused irritation or injury.

Over time, your ICD may stop working well because its wires get dislodged or broken, its battery fails, your heart disease progresses, or other devices have disrupted its electrical signaling.

Check to see whether you are at risk of heart failure. If device and medicine adjustments do not reduce your irregular heart rhythms, your doctor may suggest a procedure called ablation to stop excess electrical signals in your heart.

Check to see whether the battery needs to be replaced. Batteries in ICDs last between five and seven years. When the batteries in your device run down, you will need surgery to replace them.

Replacing the battery is less involved than the original surgery to implant the ICD. Ask your doctor whether the device generator or its wires need to be replaced, too.

Manage devices that can interfere with your ICD. To be safe, keep your ICD at least six inches away from the following devices, or, when necessary, use them only briefly: If you have an ICD on the left side of your chest, hold your cell phone to your right ear.

Most headphones have a magnetic element in them. Wear them as far away from your ICD as possible, and do not carry your headphones in a chest pocket.

Metal detectors, such as those used for airport security. The risk of harm is low, but you can show your ID card and ask for alternative inspection.

Learn the warning signs of complications and make a plan. Call your doctor if you have signs of symptoms that concern you, and if you have these signs in particular: Fainting Dizziness or feeling out of breath Fever Heart palpitations or chest pain Go to a hospital emergency room if you feel many strong shocks from your device in a short time.

Tend to your emotional health. Return to Who Needs Them? Research for Your Health. Improving health with current research. Advancing training in emergency care.

This program will support young investigators who are committed to research careers in emergency cardiovascular medicine.

Funding advances in emergency response. The Resuscitation Outcomes Consortium ROC is a clinical trial network that tests treatments to address high rates of injury and death from out-of-hospital cardiac arrest and severe traumatic injury.

Researchers are comparing how emergency response teams transport patients to the hospital to look for ways to improve outcomes. A registry of sudden cardiac arrests that ROC established has helped track important information about these events.

In , ROC data helped show that more patients survive sudden cardiac arrest in public spaces when bystanders use an AED while waiting for a standard emergency response.

Online poker in Canada is totally acceptable. Nobody has ever been charged with a crime for playing online poker in our country.

There is an often talked about law against gambling in an un-authorized gambling house, but that has never been construed to apply to web-based card rooms.

If this changes, we'll do our best to let our readers know. The real money online poker sites we list here aren't just Canadian-friendly. They are top of the line poker game websites no matter where in the world you live and that comes with certain benefits.

The safety, reliability, and security of these sites are beyond question. You can proceed confidently knowing that the reputations of these poker rooms are fantastic.

Yes, technically, they are. First of all, we would like to encourage you to comply with all Canadian laws, including the tax code. You only have to pay taxes if you come out ahead they don't tax your losses.

Canadian poker players are particularly lucky in this regard. Essentially every major real money internet poker room accepts players from Canada and Canadian-friendly deposit methods without issue.

The bonuses offered by Canadian online poker sites come in different shapes and sizes. Some are genuinely valuable while others are pretty much gimmicks designed to get new Canadian card players in the door.

Make sure to take a good hard look at the clearing requirements on the website to see if you have a realistic chance of actually receiving your bonus, based on how much you gamble.

Also, don't forget about the loyalty programs that can really add up in the long run. Every poker site is unique, and since so many of them accept Texas Hold'em players from Canada, it's hard to say how all of them deal with tournaments.

Luckily, the top poker sites for Canadians have full schedules of regular tournaments, not to mention the big monthly events that attract tons of players.

Stick with any of the tried and true top real money Canadian poker sites listed above, and you won't have to worry about a thing!

We aim to promote responsible gambling when playing poker. If you think you have a problem, take a look at the resource as Problemgambling. With countless poker sites available in Canada, it's easy to become overwhelmed.

They all sound great on the surface, so that's why our expert reviewers dive deeply into each room in order to give you the real story.

Here are some casinos that might appear to be competitive, but failed to pass our rigorous screens for real money poker games in Canada:.

We're getting reports of no withdrawal options being offered and we dread to think what will happen to any new players that sign up at Full Flush.

Stay away and invest your cash in a recommended site. In recent months there have been mounting rumours of extortionate withdrawal rake requirements and ridiculous withdrawal times up to months at EuroClub.

Stay safe and play elsewhere. Avoid this site at all costs, though it's rumoured to be now be closed. Canadian Poker Sites November 9, These online poker sites were selected for our exclusive listing because each one of them: Accepts and caters to poker players in Canada.

Offers game-changing welcome bonuses and loyalty programs. Has enough traffic to keep you playing instead of waiting around the clock. Is it legal for me to play online poker in Canada?

Are the best Canadian poker sites safe and secure?

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