The study deals with the interdisciplinary topic of the electromagnetic compatibility of the cardiac implantable electronic devices that are used in patients with a defect of heart conduction system. We are focusing on the detection of disturbing signals on electrodes of cardiostimulation device and its interpretation. The detection of electromagnetic interference (EMI) is related to electrode choice, device placement, its configuration and programming. The aim of the study is the analysis of the pacemaker response in the presence of an external source of the disturbance fields. We point to possible risks of its interaction and discuss mechanisms that can influence the pacemaker sensitivity to EMI. Due to improper signal detection, the device programming changes can occur. We present an experiment of the exposure of the cardiostimulation system to a low-frequency harmonic interference signals and finally we analyse similar clinical episode and discuss proper functioning of the pacemaker.

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The pacemaker (PCM) timing is a basic feature of the stimulation system. The device tries to bring the function of the heart with the conduction system disorder as close as possible to its original physiologically correct state. The main function of the PCM is a bradyarrhythmia therapy. Current devices are programmable and can adequately respond to any fluctuations in a heart rate from required values. Common parts of these devices are algorithms for the atrial tachycardias detection such as atrial fibrillation. The interpretation of a fast heart rate is affected by the pacemaker timing and different refractory intervals, especially in the case of tachycardias of lower frequencies. In this paper we discuss the effect of different atrial event frequencies to the adequate PCM response according to the timing behavior of the device. We prove our hypotheses by an experimental verification on the phantom of the pacemaker system by the in vitro method. The obtained results are compared with the case report from clinical practice. We set limit intervals for the detection of atrial tachycardias and verify the rate of the activation of the PCM program response for different frequencies. Finally, we discuss the behavior of cardiac implantable electronic devices (CIEDs) during the detection of signals of higher frequencies.