The Change of Cardiostimulation Device Programming Due to Detection of Electromagnetic Interference

Abstract

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.

Influence of the Arc Welding Related Electromagnetic Field on Pacemakers

“…The shape of the ventricular electrode was semicircular with a total area of 225 cm 2 , which represents the maximum achievable effective induction area formed by the electrode, as described in [8]. For dual-chamber devices, the shape of the atrial electrode corresponded to frequent fixation in the right atrial appendage [9].…”

“…Current trend is effort to minimize a risk associated with EMI, although it is not possible to completely eliminate it [1][2][3].…”

In Vitro Modeling of Implantable Cardiac Pacemakers Submitted to Conducted Disturbance

“…Such as: M: represents a square matrix (N * N), whose elements "m_ (N, N)" are numerical coefficients depending on the N unknowns (V_ (1), ...V_N), involved in the equations of the system (6).…”

“…J. Morava and A. Richter in 2020, they showed that ICEDs are subject to incorrect interpretation of electrical signals, because the device does not monitor the shape of the detected signal, according to which it can distinguish between interference and arrhythmias. Thus, the presence of electromagnetic interference signals can also cause temporary modifications to its programming and can easily affect its performance [6]. The MAUDE (The Manufacturer and User Facility Device Experience) database of the US Food and Drug Administration identified 2843 cases of medical device malfunctions induced by EMPs, between January 2010 and March 2017 [7].…”

Analýza elektromagnetického pole emitovaného při obloukovém svařování na funkci kardiostimulátoru

“…Pokud se pacient s CIED setká se zdrojem elektromagnetického pole (EMP), může za určitých okolností emitované pole ovlivnit funkci srdečního přístroje, což může mít pro pacienta vážné důsledky. [1,2,4] Mezi potenciálně nebezpečné zdroje patří také technika pro svařování elektrickým obloukem. Zdroj svařovacího proudu je schopen generovat stovky ampér a být tak zdrojem silného magnetického pole.…”