Non-cardiac implantable electrical devices: brief review and implications for anesthesiologists

Venkatraghavan, Lashmi; Chinnapa, Vinod; Peng, Philip; Brull, Richard

doi:10.1007/s12630-009-9056-3

Cited by 32 publications

(50 citation statements)

References 49 publications

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“…[9] These devices have the potential to power a new generation of implantable devices such as cardiac and gastric pacemakers, deep brain, bladder, and bone stimulators, automated drug delivery systems, artificial vision, and biosensors. [10] However, ECs are currently limited by relatively low volumetric and gravimetric capacitances, and low energy densities (energy stored per unit volume or mass) that are less than those of batteries. [11] In addition, batteries in general are considered the least “green” component in any electronic device.…”

Section: Introductionmentioning

confidence: 99%

Ultrathin Graphene–Protein Supercapacitors for Miniaturized Bioelectronics

Mosa

Pattammattel

Kadimisetty

et al. 2017

Advanced Energy Materials

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Nearly all implantable bioelectronics are powered by bulky batteries which limit device miniaturization and lifespan. Moreover, batteries contain toxic materials and electrolytes that can be dangerous if leakage occurs. Herein, an approach to fabricate implantable protein-based bioelectrochemical capacitors (bECs) employing new nanocomposite heterostructures in which 2D reduced graphene oxide sheets are interlayered with chemically modified mammalian proteins, while utilizing biological fluids as electrolytes is described. This protein-modified reduced graphene oxide nanocomposite material shows no toxicity to mouse embryo fibroblasts and COS-7 cell cultures at a high concentration of 1600 μg mL−1 which is 160 times higher than those used in bECs, unlike the unmodified graphene oxide which caused toxic cell damage even at low doses of 10 μg mL−1. The bEC devices are 1 μm thick, fully flexible, and have high energy density comparable to that of lithium thin film batteries. COS-7 cell culture is not affected by long-term exposure to encapsulated bECs over 4 d of continuous charge/discharge cycles. These bECs are unique, protein-based devices, use serum as electrolyte, and have the potential to power a new generation of long-life, miniaturized implantable devices.

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Section: Introductionmentioning

confidence: 99%

Ultrathin Graphene–Protein Supercapacitors for Miniaturized Bioelectronics

Mosa

Pattammattel

Kadimisetty

et al. 2017

Advanced Energy Materials

View full text Add to dashboard Cite

show abstract

“…[4][5][6] Examples of commonly used IEDs include deep brain stimulators, spinal cord stimulators, vagal and phrenic nerve stimulators, and gastric stimulators. Many of the issues of perioperative management are similar to those for cardiac devices, though there are specific differences.…”

Section: Noncardiac Electrical Devicesmentioning

confidence: 99%

Society position statement

Healey

Merchant

Simpson

et al. 2012

Can J Anesth/J Can Anesth

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“…Deep brain stimulation is a targeted neurosurgical intervention that enables an implanted pacemaker to electrically stimulate structures deep within the brain. 1 The system was approved by the FDA in 1997 12 for use in patients with drug-refractory essential tremor or Parkinsonian tremor that constitutes a significant functional disability. Deep brain stimulation is also indicated as an aid in the management of chronic, intractable primary dystonia, including generalized and segmental dystonia, hemidystonia, and cervical dystonia (torticollis) in individuals aged 7 and older.…”

Section: Deep Brain Stimulatorsmentioning

confidence: 99%

“…4,14 Targets for stimulation include the internal globus pallidus, subthalamic nucleus, and thalamus. 1,4,13 Implanting a device at these sites allows for individualized programming of stimulator impulse amplitude and frequency for optimal symptom management. 15 Figure 1.…”

Section: Deep Brain Stimulatorsmentioning

confidence: 99%

“…T he number of patients with implantable electronic devices (IEDs) is growing as indications for a myriad of cardiac and neurological disorders that cannot be managed using medication alone expand. 1 These devices include gastric and cardiac pacemakers, implantable cardioverter defibrillators, cochlear implants, and a range of stimulators of the deep brain, vagal nerve, sacral nerve, phrenic nerve, spinal cord, and bone. Encountering patients with an IED who present for office-based procedures is becoming increasingly common.…”

mentioning

confidence: 99%

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Electrosurgery and Implantable Electronic Devices: Review and Implications for Office-Based Procedures

Voutsalath¹,

Bichakjian²,

Pelosi³

et al. 2011

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.T he number of patients with implantable electronic devices (IEDs) is growing as indications for a myriad of cardiac and neurological disorders that cannot be managed using medication alone expand. 1 These devices include gastric and cardiac pacemakers, implantable cardioverter defibrillators, cochlear implants, and a range of stimulators of the deep brain, vagal nerve, sacral nerve, phrenic nerve, spinal cord, and bone. Encountering patients with an IED who present for office-based procedures is becoming increasingly common. Electromagnetic interference (EMI) during routine procedures has been reported to be associated with inappropriate functioning of IEDs. 2 Adverse effects of performing electrosurgery on patients with IEDs pose a patient safety risk. Medical and manufacturer reports have primarily focused on larger electrosurgical equipment used in hospitals and their effect on IEDs. Our purpose was to provide a clinical review of commonly encountered IEDs, their clinical indications, potential interference with officebased electrosurgical equipment, and recommendations to prevent complications and injury. IEDs: Clinical Indications Cardiac PacemakersAlthough pacemaker technology has advanced since the first one was implanted in 1958, 3 common indications are still symptomatic bradyarrhythmias, such as sinus node dysfunction and heart block. A pacemaker consists of a battery-powered generator connected to electronic pacing wires inserted intravenously to the right-side chambers of the heart. 4 The earliest devices were asynchronous devices, pacing the heart at a fixed rate regardless of the patient's underlying rhythm and sometimes causing symptomatic hemodynamic consequences. The latest models are demand pacemakers that sense the heart's intrinsic rhythm and inhibit pacing in the same chamber or trigger pacing in another cardiac chamber. 5,6 These devices also have sophisticated timing features to optimize heart rates and even treat some atrial arrhythmias. Implantable Cardioverter DefibrillatorsImplantable cardioverter defibrillators (ICDs) have had a profound effect on patients with ventricular tachyarrhythmias and those at risk for sudden cardiac death. 7 ICDs are programmed to treat lifethreatening ventricular arrhythmias with rapid overdrive pacing or an internal defibrillator shock. These patients most commonly have severe acquired, inherited, or idiopathic forms of cardiomyopathy. Indications continue to expand to include asymptomatic patients with low ejection fractions at risk of sudden death. Similar to pacemakers, these devices

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Non-cardiac implantable electrical devices: brief review and implications for anesthesiologists

Cited by 32 publications

References 49 publications

Ultrathin Graphene–Protein Supercapacitors for Miniaturized Bioelectronics

Ultrathin Graphene–Protein Supercapacitors for Miniaturized Bioelectronics

Society position statement

Electrosurgery and Implantable Electronic Devices: Review and Implications for Office-Based Procedures

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