How to Perform CPR on Someone with a Medical Implant (Like a Pacemaker)

When someone collapses and stops breathing, CPR can mean the difference between life and death. But some people hesitate when they notice a medical implant, such as a pacemaker or implantable cardioverter-defibrillator (ICD). The good news is that you can and should perform CPR on someone with one of these devices. The process is almost the same, with just a few small adjustments.

At Health Solutions of America, we teach you how to respond confidently in any situation—including special cases like this.

What Is a Pacemaker or ICD?

  • A pacemaker is a small, battery-powered device placed under the skin of the chest that helps regulate an irregular heartbeat.
  • An ICD (implantable cardioverter-defibrillator) monitors the heartbeat and can deliver a small shock if the heart rhythm becomes dangerously abnormal.

These devices support the heart’s rhythm but do not replace CPR during cardiac arrest. CPR is still required to maintain oxygen flow to the brain and vital organs.

If You Suspect Cardiac Arrest: Take Action Immediately

  1. Check for responsiveness — Tap the person and call out to them.
  2. Call 911 — Or instruct someone else to call and bring an AED if one is available.
  3. Start CPR — If the person is not breathing normally, begin chest compressions right away.

How to Perform CPR on Someone with a Pacemaker or ICD

1. Hand Placement

Perform CPR the same way as for any adult:

  • Place the heel of one hand in the center of the chest, on the lower half of the sternum.
  • Place your second hand on top and interlock your fingers.
  • Press 2 inches deep, at a rate of 100–120 compressions per minute.

Tip:
If you feel or see a small lump under the skin just below the collarbone, that is the implant.
Shift your hand slightly toward the center of the chest and continue compressions. Do not stop CPR.

2. Rescue Breaths (If Trained)

After every 30 compressions, give 2 rescue breaths:

  • Tilt the head back and lift the chin.
  • Pinch the nose and breathe just enough to make the chest rise.

If you are not trained in rescue breathing, perform hands-only CPR—continuous compressions until help arrives.

Using an AED on Someone with a Pacemaker or ICD

AEDs are safe to use on people who have implants. Just adjust pad placement:

  1. Turn on the AED and follow its instructions.
  2. Expose the chest and dry it if needed.
  3. Look for the implant—usually a small bulge under the skin below one collarbone.
  4. Place the AED pads at least one inch away from the device:
    • One pad on the upper right chest
    • The second pad on the lower left chest, below the armpit

Never place a pad directly over the implant.
Allow the AED to analyze and deliver a shock if needed.

Common Myths About CPR and Pacemakers

Myth Truth
CPR can damage a pacemaker. CPR does not damage implanted devices. Perform CPR as usual.
You might get shocked if the ICD activates. You will not get shocked. It is safe to keep performing CPR.
AEDs should not be used on people with implants. AEDs are intended for use on anyone in cardiac arrest, including those with medical implants.

Get CPR and First Aid Training Through Health Solutions of America

If someone with a pacemaker or ICD goes into cardiac arrest, do not hesitate—begin CPR and use an AED right away. Acting quickly can save a life.

Health Solutions of America provides online CPR and First Aid certification that teaches you how to respond in real situations, including how to help individuals with medical implants, children, infants, and pregnant women.

Contact us today to get certified and feel confident responding when it matters most.