Electromagnetic interaction between an axial left ventricular assist device and an implantable cardioverter defibrillator

Bakhtiary, Farhad; Therapidis, Panagiotis; Scherer, M.; Dzemali, Omer; Moritz, Anton; Kleine, Peter

doi:10.1016/j.jtcvs.2008.02.072

Cited by 10 publications

(5 citation statements)

References 3 publications

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“…Issues identified include the inability to interrogate implanted TV‐ICD systems as well as inappropriate therapies. There have been several reports of inability to interrogate ICDs in the presence of a HeartMate II 19‐26 . Two studies showed that the incidence of inability to interrogate St. Jude and Sorin ICDs was 2%‐17% 27,28 .…”

Section: Discussionmentioning

confidence: 99%

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Ishida

Payne

Field

et al. 2020

Cardiovasc electrophysiol

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Introduction: Interactions of left ventricular assist devices (LVADs) with transvenous implantable cardioverter-defibrillator systems (ICDs) have been widely reported. However, less is known regarding the impact of electromagnetic interference (EMI) from LVADs on subcutaneous ICD function.Methods and Results: A comprehensive literature search was performed on PubMed, Cochrane central registry, and Google Scholar using the search terms "subcutaneous implantable cardioverter-defibrillator and left ventricular assist devices," "electromagnetic interference, LVAD, and subcutaneous ICD," "EMI and S-ICD," and "inappropriate shocks, LVAD, and ICD." Demographic and programming data were extracted from the reports and authors as needed. A total of seven cases of EMI in LVAD patients with subcutaneous ICD (S-ICD) devices were found. In addition three previously unreported cases from our center were included. All cases involved either a heartware ventricular assist device or HeartMate III LVAD with a pre-existing S-ICD. In all patients, both the primary and secondary vectors had inappropriate sensing due to EMI. Three patients were reprogramed to the alternate vector with appropriate sensing. The S-ICD was either inactivated or replaced with a transvenous device in six patients. A single patient was left sensing in the alternate vector. There were no reports of inability to interrogate S-ICD systems in patients with LVADs. Conclusion:The risk of inappropriate shocks from LVADs should be considered in pre-existing patients with S-ICD, particularly when the heartware ventricular assist device or HeartMate III LVAD device is present. Reprogramming of the sensing vector can occasionally avoid this issue but often the S-ICD needs to be inactivated. K E Y W O R D S electromagnetic interference, inappropriate shock, left ventricular assist device, oversensing, subcutaneous implantable cardioverter-defibrillator

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Section: Discussionmentioning

confidence: 99%

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Ishida

Payne

Field

et al. 2020

Cardiovasc electrophysiol

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“…Specifically, the electromagnetic signal generated by the HeartMate II pulse width modulator, which serve to regulate voltage input to the LVAD motor, operate at the 7.2-kHz frequency and can interfere with the 8-kHz operating frequency of the defibrillator telemetry wand. This problem has been reported with both St. Jude Medical and Sorin Group (Milan, Italy) devices 3, 4, 5, 6…”

Section: Discussionmentioning

confidence: 59%

“…Unfortunately, electromagnetic interference emanating from the LVAD is known to occasionally severely impair telemetry communication between certain defibrillators and their programmers 3, 4, 5, 6. Specifically, the electromagnetic signal generated by the HeartMate II pulse width modulator, which serve to regulate voltage input to the LVAD motor, operate at the 7.2-kHz frequency and can interfere with the 8-kHz operating frequency of the defibrillator telemetry wand.…”

Section: Discussionmentioning

confidence: 99%

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MediGuide-assisted atrial flutter ablation in a patient with a HeartMate II left ventricular assist device

Thanh

Andrade

Dyrda

et al. 2015

HeartRhythm Case Reports

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“…Electromagnetic interference (EMI) has been shown to disrupt this communication in both HeartMate II (HMII) [17][18][19][20][21][22][23][24][25][26][27][28] and HeartMate3 (HM3) left ventricular assist devices (LVADs), [30][31][32] explained in part by the influence of the pulse-width modulator (PWM). 21,29 Other relevant factors which likely influence the strength of EMI include the distance between the LVAD and the ICD/programmer and LVAD mechanics such as rotor speed. There have been no published reports of this phenomenon occurring with the HeartWare (HW) ventricular assist device.…”

Section: Introductionmentioning

confidence: 99%

Importance of electromagnetic interactions between ICD and VAD devices—Mechanistic assessment

et al. 2022

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Background: Implanted cardioverter defibrillators (ICDs) and left ventricular assist devices (LVADs) are established interventions that prolong life in advanced heart failure, but their combination has not been demonstrated as beneficial. Electromagnetic interference (EMI) produced by a LVAD can preclude ICD interrogation with external programmers. We undertook a systematic evaluation of the LVAD-ICD interaction "in-vitro" to clarify the extent of this interaction. Methods: Using explanted ICDs and VADs in a mock physiological rig, we assessed interrogation and reprogramming of ICD devices in the presence of a running LVAD. When connectivity between the ICD programmer and the ICD failed, we attempted three different techniques to re-establish connectivity: (1) Electromagnetic shielding of the ICD with a pseudo-faraday cage; (2) altering the LVAD speed; and (3) increasing the distance between the VAD and the ICD.Results: We tested a total of 24 ICDs from different manufacturers in the presence of the Heartware (HW) and HeartMate 3 (HM3) LVADs. With HW, we only observed interaction with Biotronik ICD devices at very close range (0-6 cm).With HM3, only Medtronic ICD devices showed no interaction. Interactions could be mitigated by increasing the VAD-ICD distance.Conclusions: LVADs, notably the HM3, produce EMI that interferes with the communication between an ICD and its respective programmer. This may need to be considered when choosing the type of VAD to implant in patients with a previously implanted left-sided ICD. The only safe way to regain connectivity is to increase the distance between the VAD and the ICD, with patients raising their arm above their head.

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Electromagnetic interaction between an axial left ventricular assist device and an implantable cardioverter defibrillator

Cited by 10 publications

References 3 publications

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

Electromagnetic interference from left ventricular assist devices in patients with subcutaneous implantable cardioverter‐defibrillators

MediGuide-assisted atrial flutter ablation in a patient with a HeartMate II left ventricular assist device

Importance of electromagnetic interactions between ICD and VAD devices—Mechanistic assessment

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