As the use of Implantable Cardioverter Defibrillators (ICD) increases, greater numbers of young patients (pts) will receive these devices. Such pts may have different expectations and requirements than older pts who more commonly receive ICDs. We investigated quality of life issues in all 25 pts followed at Yale New Haven Hospital who were under age 40 years (13–40 y, m=28) at time of ICD placement. Mean time since ICD placement was 3.3 years. Four pts were excluded: 2 had devices explanted, and 2 died (1 from sepsis and 1 from arrhythmia following ICD inactivation). Cardiac diagnoses included: myocardial infarction (7), long QT syndrome (6), cardiomyopathy (6), and other (6).Each pt received a modification of the New England Medical Center health questionnaire; 16/21 responded (76%). Nine were women, and 10 were married, 3 after ICD implantation. Highest education attained was high school for 6 (37%), college for 7 (44%), and graduate school for 3 (29%). Two pts obtained graduate degrees and 4 women conceived after ICD implantation. All delivered healthy infants including 1 whose ICD discharged during pregnancy. Ten pts were employed; 8 held the same job before and after ICD placement. Two of the employed pts reported work difficulties: both reported that they accomplished less than before, and worked less carefully.All pts felt their health was good to excellent, with 6 reporting an improvement in health since placement of the lCD, and 1 reporting a moderate decrease in overall health. All felt they were capable of the activities of daily living, while 68% engaged freely in moderate physical activities. Only 31% felt able to fully participate in vigorous activities.All pts felt they were average to very attractive. However, 63% worried about how their clothes fit with the ICD and 68% worried about wearing bathing suits (89% of the women and 43% of the men). The ICD interfered somewhat with social interactions in 75% of pts, and 50% avoided social functions, while 50% worried about sexual encounters, and 44% avoided these encounters.Thus, even though these young pts have body image concerns and limit their activities, they are productive, active members of society, justifying aggressive medical therapy and social support.