Incidence of Electromagnetic Interference in Implantable Cardioverter Defibrillators

Kolb, Christof; Zrenner, Bernhard; Schmitt, Claus

doi:10.1046/j.1460-9592.2001.00465.x

Cited by 53 publications

(27 citation statements)

References 13 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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confidence: 99%

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

et al. 2007

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“…However, the noise that we found was inconsistent in that it was a transient nonphysiological noise. [6][7][8][9][10] EMI is reported to have several types of mechanisms, but usually differs from a low frequency noise pattern because it appears in all sensing channels and the noise pattern has an abrupt onset and is continuous. 11,12) Lead failures could be diagnosed by the chest radiograph, or by variations in the lead impedance.…”

Section: Discussionmentioning

confidence: 99%

Oversensing of a Particular Transient Noise Appearing After the Implantation of an Implantable Cardiac Device

Okahara

Nakano

Miyamoto

et al. 2011

Journal of Arrhythmia

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We experienced 2 cases in which oversensing of a particular noise after the implantation of an implantable cardiac device was observed in the acute phase. These were unusual cases in which the noise exhibited a low frequency pattern and appeared several hours after the implantation, but disappeared within 1 week. Here we present these cases and the details of an experiment investigating the origin of the noise and the methods for its prevention.The noise in these cases led to pacing inhibition and could have induced an inappropriate shock due to oversensing, but its morphology and electromagnetic interference were atypical for a lead failure or myopotentials. The noise spontaneously disappeared from the analysis of the data stored in the device. In an experiment based on the Irnich model, in which it was assumed that blood invaded a damaged grommet, low frequency noise occurred which was similar to the noise in the two cases. We concluded that care must be exercised when handling grommets. (J Arrhythmia 2011; 27: 68-75)

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“…In addition, the electromagnetic field used in this procedure can interfere with the electronics of the pacing device, and generate heat within the leads, potentially damaging the myocardium. (Kolb et al 2001) Echocardiography is a relatively inexpensive and commonly used imaging technique that can be safely used in patients with cardiac devices. This chapter will focus on echocardiographic techniques used to measure many aspects of cardiac function which are affected by RV pacing.…”

Section: Methods Of Quantifying LV Functionmentioning

confidence: 99%

Right Ventricular Pacing and Mechanical Dyssynchrony

Burns¹,

Gage²,

Bank³

2012

Electrophysiology - From Plants to Heart

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Incidence of Electromagnetic Interference in Implantable Cardioverter Defibrillators

Cited by 53 publications

References 13 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

Oversensing of a Particular Transient Noise Appearing After the Implantation of an Implantable Cardiac Device

Right Ventricular Pacing and Mechanical Dyssynchrony

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