Experimental study of neutron-induced soft errors in modern cardiac pacemakers

Abstract

This experiment shows the sensibility of modern pacemakers to neutron-induced soft errors and effectiveness of backup reversion in response to irradiation. The lower neutron fluence associated with a positive test was used to propose the calculation of the very low soft error rate for the tested devices in real-life atmospheric radiation.

Mitigating bit flips or single event upsets in epilepsy neurostimulators

“…Cardiac devices exposed in a controlled environment to high-density neutron beams showed a variety of responses and varied by manufacturer [4] . Single event upset risks include component thickness, battery preservation strategies, and perhaps most importantly, read and record memory functions [4] . The rate of a bit flip is a function of the device's operating voltage, semiconductor composition (wafer process), and level of exposure to radiation.…”

“…It is also necessary to educate patients on the risk factors for terrestrial cosmic radiation and promote caution. At higher altitudes, particularly commercial air travel, there is an increased amount of cosmic radiation, making SEUs in air travel up to 20% more likely [1] , [4] . Similarly, higher latitudes may place a patient at a higher risk [1] .…”

“…The cardiac literature shows progressive understanding of SEUs since pacemaker and defibrillator devices were adopted [1] , [3] , [4] . Given that a SEU in a pacer or defibrillator device could prove immediately fatal (either failure to pace or unintended/inappropriate stimulus), hardware installed on cardiac devices allows SEU detection with regression to a presumably safe default mode and later mitigation of the SEU through device reprogramming without device removal [3] , [4] . For instance, a pacemaker might default to a single chamber rate of 50 bpm, and tachycardia detections may be turned off or set for a maximum ventricular rate in one chamber only before defibrillation.…”

Spot-scanning proton therapy for targets with adjacent cardiac implantable electronic devices – Strategies for breast and head & neck cancer

“…Scattered secondary neutrons from treatment with radiotherapy cause malfunctions in cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable cardioverter defibrillators [1,2]. The primary mechanism behind is that neutrons stochastically may induce single-event upsets causing the device to reset to backup mode [3,4]. The use of proton therapy for selected patients is currently increasing [5], however, the reported experience with proton therapy for patients with CIEDs is limited [6][7][8][9].…”

Detection limit of a VCO based detection chain dedicated to particles recognition and tracking

“…Concerning medical application, a first clinical study reported in 1998 [5] has shown that cosmic neutron radiation could induce Single Event Upsets (SEU) in implanted devices and has evaluated its incidence in a large population of patients with Implantable Cardioverter Defibrillators, ICD [6]. Note that the SEU is the cell flip of a memory point following the crossing of an ionizing particle.…”