@kgiery Welcome to Connect where you have asked an important question! We are the bionic people with our pacemakers and ICDs and like you, found that there are sometimes "quirks" as we adjust to our new companions. Thank you, @jc76, @gloaming and @missy245 for your clear and informative accounting of your experiences and explanations. I acquired Buddy, my ICD, after experiencing arrythmias (dizzy, giddy and then a couple of syncope) after a septal myectomy for HCM in 2022. I am paced at 60 beats a minute, so far, no shocks. I, too, feel anxious, but I have always been an anxious person, probably part of my personality. My husband said that it has gotten worse - yet it has not prevented me from the activities of regular daily life. Perhaps keeping track of when you are feeling the anxiety and panic attacks (day, time, what you are doing, etc), and having your EP compare the data with the occurrences may point the right direction for further investigation. Perhaps consider meeting with an anxiety professional. I found this study https://pmc.ncbi.nlm.nih.gov/articles/PMC12023003/ Also: https://www.mayoclinicproceedings.org/article/S0025-6196%2811%2961510-3/fulltext Again, welcome to this blog! How did the decision to acquire your device come about?