Worries about sex can be daunting after a cardiac patient receives an implanted heart defibrillator. But, a patient’s lover likely is more worried than the patient, a new study found.
Intimate partners are often concerned that the patient will suffer cardiac arrest during sex. Some even worry that they’ll receive an electric shock if their partner’s defibrillator goes off during sex, according to research presented Monday at the American Heart Association’s annual meeting in Orlando, Fla.
The good news is that these worries taper off in the weeks following implant surgery, and three months out neither partner is typically worried about having sex, said study senior researcher Cynthia Dougherty, a professor of nursing at the University of Washington in Seattle.
And for most people with an implantable cardiac defibrillator (ICD), it’s safe to resume sexual activity once the surgical site has healed, the study authors said.
“The defibrillator is a brand-new thing for both people, and I think that sometimes we forget that getting an ICD affects a partner significantly as well,” Dougherty said.
An ICD is a small device that’s placed in the chest or abdomen. It delivers an electric shock to the heart to correct life-threatening irregular heart rhythm. It helps prevent sudden cardiac arrest, a condition where the heart unexpectedly stops beating.
In this new study, 105 sexually active couples answered a series of eight questions regarding their concerns about sex following the ICD implant procedure. The couples (with an average age of 65 for patients and 63 for partners) filled the questionnaire out twice — once when the patient left the hospital and again three months later.
About 20 percent of partners said they were worried that they would receive an electric shock from the patient if the ICD went off during sex. By comparison, only 16.5 percent of patients who’d gotten the ICD worried about getting a shock during sex.
The fear on the part of the partner without the ICD is that “if their [partner’s] heart rate goes too high, they’re going to get a shock,” Dougherty said.
An ICD shock during sex is not a common occurrence, Doughtery said. It happens to between 7 percent and 13 percent of heart patients with such an implant.
“We program them in such a way that it’s very, very unlikely that regular physical activity or sexual activity would get their heart rate going in such a way that it would trigger the device,” explained Dr. Gordon Tomaselli. He is chief of cardiology at Johns Hopkins School of Medicine in Baltimore, and a spokesman for the American Heart Association.
When it does happen, however, it’s no small matter. “It’s like a lightning bolt that goes through your body,” Dougherty said.
But the electric shock cannot be conducted to the person’s partner, regardless of the intimacy of the moment, Dougherty added.
Intimate partners also are much more concerned that sex could kill their ailing lover. About 26 percent of partners said they feared causing cardiac arrest during sex by somehow triggering a failure of the ICD to work properly. However, only 13 percent of ICD patients shared that concern.
Patients are given a set of physical activity restrictions when they leave the hospital, mainly to help their incision heal and make sure the electrical leads from the ICD to the heart don’t get pulled out, Dougherty said.
Those restrictions should not prevent sex for most patients, however, Dougherty said.
“The level of physical exertion required for sex is about the same as walking up two flights of stairs,” she said. “If a person feels comfortable walking up two flights of stairs, they should have the functional capacity for sex.”
All concerns by patients and their partners about an ICD typically declined within about three months, the study found.
These results show that both patient and partner need better counseling before leaving the hospital, Dougherty said.
“We can’t just focus on the patient,” she said. “An intimate partner’s level of comfort is also important for recovery, and their concerns warrant attention from health care providers.”
This counseling could come from the nurses or mid-level staff who regularly check in with the patient to make sure the ICD is working properly, Tomaselli said. These health care workers are trained to answer questions about the device, and could respond to sexual concerns.
“At least they can ask the question,” he said. “If you don’t ask the question, the information will never get transmitted.”
Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.
For more on implantable cardiac defibrillators, visit the U.S. National Heart, Lung, and Blood Institute.