A blow to the chest when you have a pacemaker or defibrillator

The view of a cardiac electrophysiologist, a heart rhythm specialist

For survivors and families3 min read

Chest and lung injuriesPacemakers and defibrillatorsHeart rhythmDevice checksWarning signs

In a crash, a seat belt or air bag may hit the spot over an implanted pacemaker or defibrillator. Most bumps don’t harm a heart device. Even so, a serious crash calls for a careful medical exam. Tell emergency staff what kind of device you have, where it sits and whether the hit landed right over it. Show your device ID card if you have it. [1, 2]

Speak up about symptoms at once

Chest pain, trouble breathing, fainting, strong dizziness or a new irregular heartbeat needs urgent medical care. Tell the team if your defibrillator gave you a shock during or after the crash. These symptoms could point to a chest injury, a heart problem or an issue with the device. Don’t try to figure out the cause on your own. [1, 3]

Ask whether the device needs a check

A device clinic can look over the events your device has stored. When needed, it can also test the battery and the leads, which are the wires that run to the heart. Ask whether the crash or your symptoms call for an in person check or a remote transmission. [1, 3]

Tell the team if the device site is newly swollen, very painful or looks out of place. Keep your regular device checkups even if the first exam is reassuring. [1, 3]

Know who to call later

Ask which number to call if you get dizzy later or see a new device alert. The same goes for a shock from your defibrillator. Confirm whether chest imaging or other tests showed an injury. Make sure the heart device clinic gets the record of your crash visit. [1, 3]

Questions for your care team

  1. Did you examine my chest and the device site?
  2. Do I need a device interrogation (a readout of the device) or a remote transmission?
  3. Which symptom should bring me back right away?

Copy the details from your device card

Take a photo of your device card, or write down the maker and model. [1]

Sources and further reading

  1. 1American Heart Association, living with a pacemaker
  2. 2Medtronic, impact to a heart device site
  3. 3American Heart Association, living with an implanted defibrillator

This is meant as general education from a cardiac electrophysiology view. Emergency doctors must check any chest injury. Your device team decides whether you need an interrogation and when.

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