Sexual function in adults with implantable cardioverter-defibrillators/pacemaker recipients

Abstract

Sexual function is an important component of quality of life. The present chapter examines issues concerning sex and implantable electronic devices, including sexual dysfunction and safety concerns. Performing sex involves a 3-5 metabolic equivalent effort, a gradual increase in catecholamines with a modest and short increase in heart rate and blood pressure. Overall sexual activity is safe, especially if response to moderate physical activity tested normal. Pathology based research suggests a mild increased in the incidence of myocardial infarction, specifically in men performing extra-marital sex. However, significant arrhythmia that may lead to activation of an implanted defibrillator is extremely rare. Sexual dysfunction is prevalent in patients with a cardiovascular disease including those with implantable devices. Patients with pacemakers may have sexual dysfunctions which seem attributable to older age, and not to the device. Heart failure patients implanted with a resynchronization device may benefit from improved sexual function and consequently better quality of life. Despite these low risks, "sexual avoidance" is prevalent among patients with implanted defibrillators and has several causes such as fear, anxiety and altered body image. Sex and sexuality should be actively addressed during medical consultation to relieve unjustified fears and provide patients with adequate information and treatment.