New-Generation Lithotripters for Treatment of Patients with Implantable Cardioverter Defibrillator: Experimental Approach and Review of Literature

Küfer, R.; Thamasett, Stefan; Volkmer, Björn; Hautmann, Richard E.; Gschwend, Jürgen E.

doi:10.1089/089277901750299258

Cited by 19 publications

(3 citation statements)

References 18 publications

(17 reference statements)

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“…Shocks generated by lithotripsy have been related to transitory events of loss of sensitivity and command of the CIED, as well as reversion to the safe mode; however, these situations are extremely rare. 173 When lithotripsy is required in patients with pacemaker and/or defibrillator, direct the focus away from the area of the apparatus and electrodes.…”

Section: Diseases and Conditions With Specific Features In The Permentioning

confidence: 99%

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro¹,

Yu²,

Caramelli³

et al. 2017

Arquivos Brasileiros De Cardiologia

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Section: Diseases and Conditions With Specific Features In The Permentioning

confidence: 99%

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Gualandro¹,

Yu²,

Caramelli³

et al. 2017

Arquivos Brasileiros De Cardiologia

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“…In the modern medical era a variety of techniques exist using sound waves or radiation for diagnostic and therapeutic purposes. Several authors could demonstrate that shock waves applied during extracorporeal shock wave lithotripsy (ESWL) have no influence on ICD function, even when the generators have been exposed to the focal point of the wave 2–4 . In contrast, diagnostic radiation (screening mammography) 5 and therapeutic radiation showed different modes of interference with pacemakers 6 and ICDs 7 depending on the integrated circuit (IC) technology of the devices.…”

Section: Discussionmentioning

confidence: 99%

Application of Radiofrequency Energy in Surgical and Interventional Procedures:

Fiek¹,

Dorwarth²,

Durchlaub³

et al. 2004

Pacing Clinical Electrophis

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During surgical and interventional procedures, interference may occur between ICDs and electrical cautery or with the application of RF energy. This may lead to the false induction of ICD therapies or could even result in device malfunction, which represents a potential perioperative hazard for the patient. This study analyzed the intraoperative interactions in 45 consecutive ICD patients in reference to different surgical and interventional procedures. A total of 33 surgical operations (general surgery [n = 14], urologic [n = 5], abdominal [n = 10], gynecological [n = 2], thoracic [n = 1], neurosurgical [n = 1]) and 12 interventional therapies (RF catheter ablation [n = 10], endoscopic papillotomy [n = 2]) were performed. The ICD devices were all located in left pectoral position and consisted of 25 single and 20 dual chamber defibrillators. During the procedure, tachyarrhythmia detection (VF 296 +/- 20 ms, VT 376 +/- 49 ms) of the devices was maintained active (monitoring mode), only ICD therapies were inactivated. The indifferent electrode of the electrical cauter/RF generator was placed in standard positions (right/left mid-femoral position [n = 27/8], thoracic spine area [n = 10]). After the procedure, the ICD memory was checked for detections and for changes in the programming. There was no oversensing, reprogramming, or damage of any defibrillator caused by RF energy. Despite the lack of undesired interactions, ICDs should be inactivated preoperatively to assure maximum patient safety. However, should inactivation not be possible, or the achievement uncertain, electromagnetic interference is highly unlikely.

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“…89 In vitro testing of two ICDs with a new generation lithotripter did not disclose adverse interactions (even when the generator was placed within the focus of the lithotripter), provided the shockwaves were applied synchronized to the R wave. 91 There is limited clinical experience with the use of ESWL in patients with pacemakers or ICDs. Drach et al 92 reported only four mild complications in a worldwide series of 131 pacemaker patients.…”

Section: Lithotripsymentioning

confidence: 99%