Pacemaker Interference with Screening Mammography

Roelke, Marc; Rubinstein, Valeria J.; Kamath, Shuba; Krauser, Daniel G.; Ngarmukos, Tachapong; Parsonnet, Victor

doi:10.1111/j.1540-8159.1999.tb00581.x

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…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. Therapeutic diathermy may cause problems by heating the device or burning the tissue close adjacent to the ICD 8 .…”

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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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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“…In the scientific literature, little is known about mammography in females with an IMD. Roelke et al 3 report that part of the mammogram was obscured in 12% of the females with a pacemaker. To our knowledge, this is the only study that has reported on the mammographic image quality in females with an IMD.…”

Section: Introductionmentioning

confidence: 99%

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Paap¹,

Witjes²,

Landsveld-Verhoeven³

et al. 2016

BJR

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Objective: To assess the image quality of mammograms in females with an implanted medical device (IMD), to evaluate pain and anxiety during mammography in these females and to investigate the experience of radiographers. Methods: Image quality was evaluated by two radiographers and one radiologist in the images of females with an IMD participating in the Dutch screening programme (clients). Pain and anxiety were scored using a Numeric Rating Scale in both clients visiting a screening organization and patients from the Isala Hospital, Zwolle. Experience of screening radiographers was collected with a questionnaire. Results: Images of the breast with IMD showed reduced contrast in craniocaudal (CC) and mediolateral-oblique (MLO) views [by both the radiographers and radiologist (range: 11-29%)], less projected breast tissue [only radiographers; CC lateral side: 25.5%, 95% confidence interval (CI): 18.7-32.2] and reduced projection of the pectoral muscle (only radiographers; MLO width pectoral muscle: 31.5%, 95% CI: 24.4-38.7). Clients experienced more pain and anxiety during mammography in the breast with IMD compared to the breast without IMD in the breast (pain difference CC: 0.48 6 0.16, p 5 0.003; pain difference MLO: 0.46 6 0.16, p 5 0.004; anxiety difference 1.30 6 0.22; p , 0.001). Patients experienced more pain (1.05 6 0.12; p , 0.001) and anxiety (1.22 6 0.15; p , 0.001) after placement of IMD. Radiographers are more cautious, more anxious and use less compression during mammography of breasts with IMD. Conclusion: Image quality in a breast with an IMD could be improved by projecting more breast tissue on the mammogram, thereby including (part of) the IMD between the paddles, if required. In addition, radiographers should pay sufficient attention to reducing discomfort both before and during the screening examination. Advances in knowledge: Little is known about the quality of mammography in females with an IMD or how these females and radiographers experience the screening examination. The results of our study showed that having an IMD could result in a suboptimal mammogram and increased discomfort.

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Female Aspects of Electrocardiography and Cardiac Arrhythmias

Maas

Evertz

2017

Manual of Gynecardiology

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Pacemaker Interference with Screening Mammography

Cited by 6 publications

References 7 publications

Application of Radiofrequency Energy in Surgical and Interventional Procedures:

Application of Radiofrequency Energy in Surgical and Interventional Procedures:

Mammography in females with an implanted medical device: impact on image quality, pain and anxiety

Female Aspects of Electrocardiography and Cardiac Arrhythmias

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