The idea of having heart-pounding sex is exciting to many people, but a new study found that sexual excitement can turn to anxiety for people who have had electrical heart devices implanted.

The study found that patients with implanted cardioverter defibrillators often experienced a high level of anxiety about  sex, fearing that the device would deliver a painful shock as they reached climax, which of course doesn’t do much for sexual performance, according to research scheduled for presentation at  Tuesday’s meeting of the American Heart Association.

ICDs are about the size of a pager and can prevent patients with heart arrhythmias or congenital heart disease from going into sudden cardiac arrest. If the ICD detects an irregular heartbeat, it  shocks the heart back to a normal rhythm. Though lifesaving, these shocks can be painful, and many patients report that an ICD shock can feel like a kick in the chest.

Researchers asked 151 people, 41 of whom had an ICD, about their sexual arousal, performance  and satisfaction. The patients with ICDs also rated their levels of anxiety over getting an ICD shock. Men and women with ICDs who had higher levels of shock-related anxiety had lower sexual function scores. The researchers suggested that this anxiety could be alleviated if doctors counseled their patients when they got an ICD implanted.

“It’s a huge deal that no one talks about sexual function with these patients,” study author Dr. Steven Cook told U.S. News and World Report.

The Mayo Clinic said that people with ICDs should be able to return to strenuous activities, such as exercise and sex, within a few weeks after surgery. But Dr. Albert Levy, assistant professor of medicine at Mount Sinai School of Medicine, said patients should make sure they are ready for the physical excitement of sex before they get intimate.

“When you have sex, it’s the equivalent of climbing stairs,” Levy said. “If someone is capable of climbing stairs without their ICD kicking in, they should be able to have sex.”

Physical reconditioning, with the help of a physician or a physical trainer, can increase patients’ endurance and physical strength and make them ready for sex, Levy said.