Interference in Implanted Cardiac Devices, Part II

Pinski, Sergio L.; Trohman, Richard G.

doi:10.1046/j.1460-9592.2002.01496.x

Cited by 129 publications

(87 citation statements)

References 86 publications

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“…The presence of these devices, however, is currently considered a contraindication to MRI. [1][2][3][4] Nevertheless, there is an increasing need to image patients with implantable devices because of the advantages offered by MRI.…”

mentioning

confidence: 99%

“…1,2 In the past, it has been noted that the MR environment and MRI scanning have the potential to induce several hazardous effects, among which are device inhibition, rapid pacing, mechanical pull and rotation of the device, device failure, device reprogramming, and lead heating. [2][3][4][5][6][7][8][9] Current devices, however, are smaller, with less magnetic material and improved electromagnetic interference (EMI) protection.…”

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confidence: 99%

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Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

et al. 2004

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Background-MRI has unparalleled soft-tissue imaging capabilities. The presence of devices such as pacemakers and implantable cardioverter/defibrillators (ICDs), however, is historically considered a contraindication to MRI. These devices are now smaller, with less magnetic material and improved electromagnetic interference protection. Our aim was to determine whether these modern systems can be used in an MR environment. Methods and Results-We tested in vitro and in vivo lead heating, device function, force acting on the device, and image distortion at 1.5 T. Clinical MR protocols and in vivo measurements yielded temperature changes Ͻ0.5°C. Older (manufactured before 2000) ICDs were damaged by the MR scans. Newer ICD systems and most pacemakers, however, were not. The maximal force acting on newer devices was Ͻ100 g. Modern (manufactured after 2000) ICD systems were implanted in dogs (nϭ18), and after 4 weeks, 3-to 4-hour MR scans were performed (nϭ15). No device dysfunction occurred. The images were of high quality with distortion dependent on the scan sequence and plane. Pacing threshold and intracardiac electrogram amplitude were unchanged over the 8 weeks, except in 1 animal that, after MRI, had a transient (Ͻ12 hours) capture failure. Pathological data of the scanned animals revealed very limited necrosis or fibrosis at the tip of the lead area, which was not different from controls (nϭ3) not subjected to MRI. Conclusions-These

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confidence: 99%

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

et al. 2004

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“…[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. Furthermore, lead fractures may be a factor with long-term complications.…”

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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“…96 Radiation therapy may pose the risk of random failure of individual components of the device, sudden loss of output, alternations in programming, rate runaway (nonphysiological rapid delivery of pacing stimuli to the heart), and premature battery depletion 97,98 ; nonetheless, it may be unavoidable in certain device patients. Strategies to minimize this risk entail close discussion with the radiation therapist on appropriate shielding of the generator; rarely, repositioning of the generator or placement of a new system in the contralateral chest may be required.…”

Section: Drugs Devices and Emimentioning

confidence: 99%

Contemporary Pacemaker and Defibrillator Device Therapy

Schoenfeld

2007

Circulation

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Interference in Implanted Cardiac Devices, Part II

Cited by 129 publications

References 86 publications

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

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

Contemporary Pacemaker and Defibrillator Device Therapy

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