Electromagnetic Interference in Cardiac Rhythm Management Devices

Sweesy, Mark W.; Holland, James L.; Smith, Kerry W.

doi:10.1097/00044067-200407000-00007

Cited by 40 publications

(27 citation statements)

References 22 publications

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“…1 Electrical noise-related, inappropriate detection by implantable cardioverterdefibrillator (ICD) has been documented. 2,3 Detection of NID discharge by ICD has been described, 4,5 but the effects of duration of NID discharge and ICD detection and therapy have not been established. The authors hypothesized that a longer duration of NID energy might lead to shocks from the defibrillator.…”

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confidence: 99%

Duration of Discharge of Neuromuscular Incapacitating Device and Inappropriate Implantable Cardioverter-Defibrillator Detections

et al. 2007

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N euromuscular-incapacitating devices (NID) are being used increasingly worldwide by law-enforcement authorities to restrain violent behavior. 1 Electrical noise-related, inappropriate detection by implantable cardioverterdefibrillator (ICD) has been documented. 2,3 Detection of NID discharge by ICD has been described, 4,5 but the effects of duration of NID discharge and ICD detection and therapy have not been established. The authors hypothesized that a longer duration of NID energy might lead to shocks from the defibrillator. 4 With the approval of the animal care committee of our institution, we tested this hypothesis in a pig implanted with Medtronic 7275 GEM III DR ICD. The method used for performing the experiment in a pig model has been described previously. 6 In the present study, we used subcutaneous insertion of the darts. Particular attention was given to ensure that the darts were in the subcutaneous tissue and not any deeper, to avoid any possibility of direct stimulation through the pericardium. Two darts were placed: one in the right parasternal region, 5 cm from the midline; and another at the left lateral border of the thorax. The interdart distance was 30 cm. The NID energy was delivered for 5 and 15 s across the chest, using the M26 TASER (TASER International, Scottsdale, Ariz). When the NID discharge was delivered for 5 s, the device detected NID energy as ventricular fibrillation (VF), but no ICD shock was delivered; during charging of the capacitors, the device reconfirmed that the episode had terminated (Figure 1). However, when the NID energy was delivered for a longer time (15 s), the device detected NID energy as VF, and a shock was delivered ( Figure 2A). As the NID energy continued, the device redetected this as VF, and even though the NID delivery had stopped during capacitor charging, a second ICD shock was delivered because the device was in committed mode during the second therapy for VF ( Figure 2B).The implications of the present study are that (1) in patients with more recent devices, longer (15 s) NID energy delivery could result in ICD discharge; (2) because most devices are committed to deliver a shock after the first VF therapy, inappropriate shock may be delivered during sinus rhythm, even after NID energy is no longer being delivered; and (3) with older ICD models that only have committed shock delivery, even a short burst of NID energy delivery could result in inappropriate ICD discharges.

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Duration of Discharge of Neuromuscular Incapacitating Device and Inappropriate Implantable Cardioverter-Defibrillator Detections

et al. 2007

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“…Die Neutralelektrode (Kauterplatte) sollte möglichst weit vom SM-System platziert und eine Kauteranwendung im Umkreis von weniger als 15 cm vom SM-Generator vermieden werden [75,76]. Prinzipiell kann es durch Hochfrequenzchirurgie zu Hemmung und/oder Triggerung des SM-Systems, aber auch zu Änderungen des Stimulationsmodus kommen [8,9,19,24,26,50,56,60,65,70,74,84,90,100,103,105]. Eine kontinuierliche Anwendung verursacht normalerweise ein Umschalten des SM in den asynchronen "noise interference mode", während intermittierendes Kautern zu jeweils vorüberge-hender Hemmung führen kann und ungünstigstenfalls längere Pausen bis hin zur Asystolie möglich sind [86].…”

Section: Quellen Elektromagnetischer Interferenzunclassified

“…Bei starken Störsignalen treten auch andere Stimulationsformen wie asynchrone Stimulation (Noise interference mode) oder dauerhaftes Umschalten in einen ResetModus auf [6]. Die Wahrscheinlichkeit für ein bestimmtes Verhalten hängt neben Intensität und Frequenz der Stör-strahlung auch von der Dauer der Einwirkung ab [99,100,110]. Die Folgen einer durch EMI verursachten SM-Fehlfunktion für Patienten sind davon abhängig, ob der Patient einen Eigenrhythmus besitzt oder nicht.…”

Section: Schrittmacherfehlfunktionenunclassified

Perioperative management of patients with implanted pacemakers or cardioverter/defibrillators

Gombotz

Monti²,

Leitgeb³

et al. 2009

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The perioperative risk for patients with pacemakers or implanted cardioverter/defibrillators (ICD) is mainly dependent on the underlying disease. However, severe to life-threatening complications of the implanted system can occur due to electromagnetic interference in the environment of the operation. These complications can be prevented or adequately treated by taking special precautions and measures. Even though the currently available data on the optimal perioperative management to pacemakers and ICDs is still unsatisfactory, the increasing clinical relevance of this topic was the reason for the formulation of recommendations by an interdisciplinary working group in Austria.

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“…Patients with cardiac pacemakers or implantable cardiac defibrillators (ICDs) should be careful of environmental electromagnetic interference (EMI), which can cause serious device dysfunction [4][5][6]. For example, magnetic resonance imaging is a definite contraindication in these patients, as the strong magnetic field confuses and resets the pacing program and can lead to fatal consequences [7].…”

Section: Introductionmentioning

confidence: 99%

Safety of Capsule Endoscopy Using Human Body Communication in Patients with Cardiac Devices

et al. 2012

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Electromagnetic Interference in Cardiac Rhythm Management Devices

Cited by 40 publications

References 22 publications

Duration of Discharge of Neuromuscular Incapacitating Device and Inappropriate Implantable Cardioverter-Defibrillator Detections

Duration of Discharge of Neuromuscular Incapacitating Device and Inappropriate Implantable Cardioverter-Defibrillator Detections

Perioperative management of patients with implanted pacemakers or cardioverter/defibrillators

Safety of Capsule Endoscopy Using Human Body Communication in Patients with Cardiac Devices

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