Effects of External Electrical and Magnetic Fields on Pacemakers and Defibrillators

Beinart, Roy; Nazarian, Saman

doi:10.1161/circulationaha.113.005697

Cited by 134 publications

(108 citation statements)

References 99 publications

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“…These concerns are a consequence of the potential for magnetic fieldinduced cardiac lead heating, which could result in myocardial thermal injury and detrimental changes in pacing properties. [1][2][3] As a result, it has long been recommended that patients with an implanted cardiac device not undergo MRI scanning, even when it otherwise may be considered to be the most appropriate diagnostic imaging method for the patient's clinical care. 4 Over the past two decades, cardiac devices have been designed to reduce the potential risks associated with MRI.…”

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confidence: 99%

Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator

et al. 2017

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BACKGROUNDThe presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverterdefibrillator (ICD) that was "non-MRI-conditional" (i.e., not approved by the Food and Drug Administration for MRI scanning). METHODSPatients in the registry were referred for clinically indicated nonthoracic MRI at a field strength of 1.5 tesla. Devices were interrogated before and after MRI with the use of a standardized protocol and were appropriately reprogrammed before the scanning. The primary end points were death, generator or lead failure, induced arrhythmia, loss of capture, or electrical reset during the scanning. The secondary end points were changes in device settings. RESULTSMRI was performed in 1000 cases in which patients had a pacemaker and in 500 cases in which patients had an ICD. No deaths, lead failures, losses of capture, or ventricular arrhythmias occurred during MRI. One ICD generator could not be interrogated after MRI and required immediate replacement; the device had not been appropriately programmed per protocol before the MRI. We observed six cases of self-terminating atrial fibrillation or flutter and six cases of partial electrical reset. Changes in lead impedance, pacing threshold, battery voltage, and P-wave and R-wave amplitude exceeded prespecified thresholds in a small number of cases. Repeat MRI was not associated with an increase in adverse events. CONCLUSIONSIn this study, device or lead failure did not occur in any patient with a non-MRIconditional pacemaker or ICD who underwent clinically indicated nonthoracic MRI at 1.5 tesla, was appropriately screened, and had the device reprogrammed in accordance with the prespecified protocol. (Funded by St. Jude Medical and others; MagnaSafe ClinicalTrials.gov number, NCT00907361.)

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confidence: 99%

Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator

et al. 2017

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“…The new-generation-implanted cardiac pacemakers are considered to be impervious to most sources of interference because of their construction, which encapsulates components in a stainless steel or titanium cover, and are equipped with an interference mode [7,15,33]. In addition, these new devices have bipolar leads and capacitors that effectively filter out electromagnetic interference and, thus, reduce external interference [34,35].…”

Section: Discussionmentioning

confidence: 99%

Influence and safety of electronic apex locators in patients with cardiovascular implantable electronic devices: a systematic review

Alrahabi

Ghabbani

2018

Libyan Journal of Medicine

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The widespread use of cardiovascular implantable electronic devices has increased concerns regarding using electronic apex locators in patients with these devices. This systematic review investigated the effects and safety of using electronic apex locators in patients with cardiovascular implantable electronic devices.Methods: An electronic search in the Cochrane Library, PubMed (MEDLINE), ScienceDirect, and Scientific Electronic Library Online (Scielo) databases for relevant articles published between December 2000 and December 2018 was performed. The search strategy centered on terms related to electronic apex locators use during root canal treatment in patients with cardiovascular implantable electronic devices.Results: Seven studies (five in vitro and two in vivo) fulfilled the inclusion criteria for this review. It was found that electronic apex locators can be used safely in patients with cardiovascular implantable electronic devices, when general precautions are followed.Conclusions: Although the present review suggests that electronic apex locators can be used safely in patients with implantable cardioverter defibrillators, consultation with patients’ cardiologists remains advisable.

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“…9 Fortunately, modern pulse generators and leads are less sensitive to EMI due to the development of improved shielding, and we typically do not see adverse interactions. 10 It is also important to consider that programming devices to address asynchronous pacing during catheter ablation can be associated with a low but possible risk of ventricular fibrillation/tachycardia, because of the pacing on the T-wave that occurs during the vulnerable ventricular period and/or short-long-short sequence. 11,12 Meanwhile, cryoablation has not been reported to cause interference with CIED pulse generator function.…”

Section: ) Effects On the Pulse Generatormentioning

confidence: 99%

The Effects of Catheter Ablation on Permanent Pacemakers and Implantable Cardiac Defibrillators

Darrat

Morales

Elayi

2017

JICRM

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Effects of External Electrical and Magnetic Fields on Pacemakers and Defibrillators

Cited by 134 publications

References 99 publications

Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator

Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator

Influence and safety of electronic apex locators in patients with cardiovascular implantable electronic devices: a systematic review

The Effects of Catheter Ablation on Permanent Pacemakers and Implantable Cardiac Defibrillators

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