Guidance of Clinical Magnet Application of Inhibition of Inappropriate Shock in Patient of Subcutaneous Implantable Cardioverter Defibrillators: A Review of the Literature

Santomauro, Maurizio

doi:10.33552/ojcrr.2021.05.000605

Cited by 2 publications

(4 citation statements)

References 24 publications

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“…Our findings highlight the importance of using the correct magnet type for attempting S‐ICD evoked magnet response. For TV‐ICDs the two types of magnets are used interchangeably, and it has been suggested that this could also apply to S‐ICDs 11 . Our findings suggest that using a bar magnet, particularly for obese patients, could result in unreliable evoked magnet response and therefore we do not recommend their use with S‐ICD patients.…”

Section: Discussionmentioning

confidence: 78%

“…Given the potentially serious consequences of unsuccessful evoked magnet response it is important for healthcare workers that interface with S‐ICDs to be educated and aware of differences in device management between S‐ICDs and TV‐ICDs. This is echoed in a recent S‐ICD literature review, 11 which recommended S‐ICD deactivation protocols and support for S‐ICD device management be easily accessible.…”

Section: Discussionmentioning

confidence: 99%

“…Maurizio et al 11 . discusses in a contemporary literature review of S‐ICD magnet inhibition that magnet use with S‐ICDs can be unreliable.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 In a study looking at iPhone 12 magnet response the S-ICD was the only pacemaker or defibrillator not effected. 10 Maurizio et al 11 discusses in a contemporary literature review of S-ICD magnet inhibition that magnet use with S-ICDs can be unreliable. The S-ICD user manual 12 acknowledges that in patients with 'deep implants' , magnet application may fail to elicit a magnet response resulting in failure to inhibit therapies.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants

Richman

Stanton

Fryer

et al. 2022

Pacing Clinical Electrophis

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Introduction The manufacturer of subcutaneous implantable cardioverter defibrillators (S‐ICDs) acknowledges that ‘deep implants’ may fail to elicit a magnet response, however, does not define ‘deep implant’ or recommend a maximum implant depth. This study aims to systematically evaluate the effect of subcutaneous tissue depth and magnet types on evoked magnet response. Methods Sunshine Coast University Hospital's S‐ICD cohort underwent magnet response evaluation; where bar and donut magnets were compared and the evoked magnet response was recorded in three separate zones, guided by a template. Ordinal regression (OR) models assessed the relationship between the evoked magnet response and tissue depth (TD), measured via post‐implant X‐Ray. The patient's ability to hear the magnet response audible tone was recorded. Results Patients (n = 39) with measurable TD (n = 30) were analyzed. The bar magnet evoked a magnet response in all zones in 53% of patients, compared with 73% of patients with the donut magnet (p = 0.18). The relationship between bar magnet response and TD showed the odds of an evoked magnet response decreased by 11% every 1 mm increase in TD (OR of 0.89, p < 0.01), whereas the donut magnet decreased by 16% per 1 mm (OR of 0.84, p < 0.01). Directly over the S‐ICD was the most effective in evoking magnet response with the bar (85% of patients), and off‐centre was most effective for the donut magnet (100%). BMI and Praetorian score were not significantly associated with magnet response. We found 23% of patients were unable to detect the audible tone. Conclusion We observed a statistically significant association between TD and ability to evoke magnet response. The bar magnet was less reliable than the donut magnet for therapy inhibition in deep implants.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

“…Maurizio et al 11 . discusses in a contemporary literature review of S‐ICD magnet inhibition that magnet use with S‐ICDs can be unreliable.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants

Richman

Stanton

Fryer

et al. 2022

Pacing Clinical Electrophis

View full text Add to dashboard Cite

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Safety and Efficacy of Magnet Use to Temporarily Inhibit Inappropriate Subcutaneous Implantable Cardioverter Defibrillator Therapy in Emergency Situations: A Case Report

Santomauro¹,

Riganti

Santomauro³

et al. 2022

Journal of Cardiovascular Emergencies

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Introduction: The subcutaneous implantable cardioverter defibrillator (S-ICD) represents a major advancement in ICD technology. Inappropriate shocks (IAS) occur in more than 3.1% of the population with S-ICD each year and are usually followed by admission to the emergency department (ED). In this setting, the disabling of IAS is mandatory during a pseudo-electrical storm (ES). This report describes the strategies that can be followed in order to temporarily inhibit IAS in critical care settings with the use of magnets. Case presentation: An S-ICD was implanted more than 6 weeks prior to presentation in a 68-year-old man with hypertrophic cardiomyopathy. In the ED, the patient experienced 3 IAS in the last hour. A Medtronic magnet was applied to stop IAS, as the specific programmer was not available. The maneuver interrupted the IAS. In order to verify the universal magnetic response of the S-ICD, six different magnets and one smartphone with MagSafe technology were tested. All magnet models suspended arrhythmia detection and IAS, while the smartphone did not cause magnet interferences. Conclusions: This report demonstrates the safety and efficacy of all clinical magnet models in inhibiting IAS. In case of pseudo-ES, any type of magnet allows ED providers to easily and rapidly disable the functionality of the devices when appropriate.

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Guidance of Clinical Magnet Application of Inhibition of Inappropriate Shock in Patient of Subcutaneous Implantable Cardioverter Defibrillators: A Review of the Literature

Abstract: This work is licensed under Creative Commons Attribution 4.0 License OJCRR.MS.ID.000605.

Cited by 2 publications

References 24 publications

Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants

Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants

Safety and Efficacy of Magnet Use to Temporarily Inhibit Inappropriate Subcutaneous Implantable Cardioverter Defibrillator Therapy in Emergency Situations: A Case Report

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