INTERFERENCE FROM A HAND-HELD RADIOFREQUENCY REMOTE-CONTROL CAUSING DISCHARGE OF AN IMPLANTABLE DEFIBRILLATOR
INTERFERENCE FROM A HAND-HELD RADIOFREQUENCY REMOTE-CONTROL CAUSING DISCHARGE OF AN IMPLANTABLE DEFIBRILLATOR
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DOI：
10.1111/j.1540-8159.1993.tb01049.x
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发表时间：
1993-08-01
影响因子：
1.8
通讯作者：
KALBFLEISCH, SJ
中科院分区：
文献类型：
--
作者：
MAN, KC;DAVIDSON, T;KALBFLEISCH, SJ
一位有持续性单形性室性心动过速病史的46岁男性患者接受了第三代可编程植入性心律转复除颤器的植入。植入一年后，当患者操纵射频调制玩具车的遥控器时，患者经历了除颤器放电，而不是心律失常的前驱症状。随后对除颤器的询问显示，已经发出了34焦耳的电击，在此之前有141-406毫秒的RR间期，与感应到的铅噪声一致。遥控器使用12伏电池，载频为75.95 MHz，调制频率为50赫兹。对遥控器和除颤器相互作用的评估表明，遥控器能够触发对快速性心律失常的感知并再现临床发作。只有当遥控器距离脉冲发生器不到8厘米，并且与设备成特定角度，并且天线长度为45厘米时，才会出现干扰。当天线上接上地线并在脉冲发生器和遥控器之间放置铝屏蔽物时，干扰就消除了。这份病例报告建议，使用第三代多程序除颤器的患者应谨慎，不要与潜在的电磁干扰源密切接触，如遥控装置。
A 46-year-old man with a history of sustained monomorphic ventricular tachycardia underwent an implantation of a third generation multiprogrammable implantable cardioverter defibrillator. One year post implant, while manipulating a remote control to a radiofrequency modulated toy car, the patient experienced a defibrillator discharge not preceded by an arrhythmia prodrome. Subsequent interrogation of the defibrillator revealed that a 34-joule shock had been delivered and had been preceded by RR intervals ranging from 141-406 msec, consistent with sensing lead noise. The remote control utilizes a 12-volt battery and has a carrier frequency of 75.95 MHz and a modulating frequency of 50 Hz. Evaluation of the remote control and defibrillator interaction revealed that the remote control was able to trigger tachyarrhythmia sensing and reproduce the clinical episode. Interference was present only when the remote control was within 8 cm of the pulse generator and at specific angles relative to the device and only when the antenna length was > 45 cm. Interference was eliminated when a ground wire was attached to the antenna and when an aluminium shield was placed between the pulse generator and the remote control. This case report suggests that patients with third generation multiprogrammable defibrillators should be cautioned against close contact with potential sources of electromagnetic interference, such as remote control units.