Electromagnetic Interference With Implantable Cardioverter-Defibrillators at Power Frequency An In Vivo Study
Electromagnetic Interference With Implantable Cardioverter-Defibrillators at Power Frequency An In Vivo Study
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DOI：
10.1161/circulationaha.113.003081
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发表时间：
2014-01-28
期刊：
影响因子：
37.8
通讯作者：
Silny, Jiri
中科院分区：
文献类型：
--
作者：
Napp, Andreas;Joosten, Stephan;Silny, Jiri
背景用于预防心源性猝死的植入式心律转复器（ICD）的数量持续增加。由于ICD的技术复杂性，它是至关重要的，以确定和控制可能有害的电磁干扰之间的各种来源的电磁场和ICD在日常生活和职业environments.Methods和ResultsInterference阈值的110 ICD患者（1-，2-，和3-腔ICD）进行了评估，在一个专门开发的测试网站。患者暴露于强度高达30 kV·m− 1和2.55 mT的50 Hz单一和组合电场和磁场。测试是在考虑最坏情况的情况下进行的，包括设备的最大灵敏度或完全吸气。当器械程控为标称灵敏度时，91例患者（83%）的ICD未受影响。110件器械中有5件（5%）显示出准确右心室感知的短暂丧失，而31件2腔和3腔器械中有14件（45%）显示出右心房感知受损。在71例患者（65%）中未检测到干扰，在测试范围内编程到最大灵敏度，而110名受试者中有20名（18%）表现出右心室干扰，31名受试者中有19名（61%）表现出右心房干扰。然而，在某些职业环境中存在的强50 Hz电磁场可能会导致不适当的感知，从而可能导致心房/心室起搏事件的错误检测。当比较右心房/右心室干扰时，心房电极导线对电磁场更敏感。临床试验注册URL：http://clinicaltrials.gov/ct2/show/NCT01626261。唯一标识符：NCT 01626261。
BackgroundThe number of implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death is continuing to increase. Given the technological complexity of ICDs, it is of critical importance to identify and control possible harmful electromagnetic interferences between various sources of electromagnetic fields and ICDs in daily life and occupational environments.Methods and ResultsInterference thresholds of 110 ICD patients (1-, 2-, and 3-chamber ICDs) were evaluated in a specifically developed test site. Patients were exposed to single and combined electric and magnetic 50-Hz fields with strengths of up to 30 kV·m−1and 2.55 mT. Tests were conducted considering worst-case conditions, including maximum sensitivity of the device or full inspiration. With devices being programmed to nominal sensitivity, ICDs remained unaffected in 91 patients (83%). Five of 110 devices (5%) showed transient loss of accurate right ventricular sensing, whereas 14 of 31 (45%) of the 2- and 3-chamber devices displayed impaired right atrial sensing. No interference was detected in 71 patients (65%) within the tested limits with programming to maximum sensitivity, whereas 20 of 110 subjects (18%) exhibited right ventricular disturbances and 19 of 31 (61%) subjects exhibited right atrial disturbances.ConclusionsExtremely low-frequency daily-life electromagnetic fields do not disturb sensing capabilities of ICDs. However, strong 50-Hz electromagnetic fields, present in certain occupational environments, may cause inappropriate sensing, potentially leading to false detection of atrial/ventricular arrhythmic events. When the right atrial/right ventricular interferences are compared, the atrial lead is more susceptible to electromagnetic fields.Clinical Trial RegistrationURL: http://clinicaltrials.gov/ct2/show/NCT01626261. Unique identifier: NCT01626261.