An in vitro Evaluation of the Effect of Transient Electromagnetic Fields on Pacemakers and Clinical Mitigation Measures.
An in vitro Evaluation of the Effect of Transient Electromagnetic Fields on Pacemakers and Clinical Mitigation Measures.
复制标题
瞬态电磁场对起搏器影响的体外评估及临床缓解措施
DOI：
10.3389/fcvm.2020.607604
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发表时间：
2020
影响因子：
3.6
通讯作者：
Huang D
中科院分区：
文献类型：
--
作者：
Huang J;Lin K;Lu W;Ding R;Wu B;Cai M;Nazarian S;Zhao W;Li J;Huang D
背景：瞬态电磁场对起搏器功能的影响尚未得到很好的评价。临床医生在植入起搏器过程中缺乏降低电磁敏感性（EMS）的有效方法。本研究旨在评估一种处理囊袋中多余导线的新方法是否可以降低起搏器的EMS，从而减少瞬态电磁场对起搏器造成的电磁干扰的影响。方法：建立离体胸部模型，模拟双腔起搏器植入的临床情况。三种不同的缠绕模式的多余的引线进行了检查：平行，双绞线一次，和多个双绞线。将振荡电流注入模型上方水平设置的铜电线中，以产生辐射磁场，模拟起搏器的瞬态日常电磁暴露。测量了电流的电磁感应强度。当施加感应脉冲电压时，评估了EMS相关不良事件的发生率。结果：瞬变电磁场可在起搏环中产生电磁噪声，抑制起搏脉冲的释放。多余导线的多双绞线缠绕模式与较低的感应电压幅度比平行和一次缠绕模式（P < 0.001）。即使扭转一次也能显著降低感应电压幅值（P < 0.001）。多双绞线组起搏抑制发生率也低于其他两组（P < 0.001）。结论：瞬变电磁场可引起起搏抑制。将多余的电极导线在囊袋内多圈扭转是减少双腔起搏器EMS的有效方法。
Background: The effect of transient electromagnetic fields on the function of pacemakers is not well-evaluated. There is a lack of effective methods for clinicians to reduce electromagnetic susceptibility (EMS) during implantation of pacemakers. This study aimed to evaluate whether a novel method of handling the excess leads in the pocket can lower the EMS of pacemakers and consequently reduce the effect of electromagnetic interference caused by transient electromagnetic fields on pacemakers. Methods: An in vitro chest model was established to simulate the clinical condition of dual-chamber pacemaker implantation. Three different intertwining patterns of excess leads were examined: parallel, twisted once, and multiple twisted-pair. Oscillated currents were injected into a copper electrical wire set horizontally above the model to create a radiated magnetic field to simulate the transient daily electromagnetic exposure of pacemakers. The electromagnetic induction of current was measured. The occurrence of EMS-related adverse events was evaluated when the induced pulsed voltage was applied. Results: Transient electromagnetic fields can induce electromagnetic noise in the pacing loop and inhibit the release of pacing pulses. The multiple twisted-pair intertwining pattern of excess leads was associated with a lower induced voltage amplitude than both the parallel and once-twisted patterns (P < 0.001). Even once twisted could significantly reduce induced voltage amplitude compared to not twisted (P < 0.001). A lower incidence of pacing inhibition was also observed in the multiple twisted-pair group than in the other two groups (P < 0.001). Conclusions: Transient electromagnetic fields can cause pacing inhibition. Twisting the excess leads for multiple turns in the pocket is an effective method to reduce the EMS of the dual-chamber pacemaker.
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影响因子：
37.8
作者：
Beinart, Roy;Nazarian, Saman
通讯作者：
Nazarian, Saman
影响因子：
1.9
作者：
Huang, Dong;Dong, Zhi-Feng;Li, Jing-Bo
通讯作者：
Li, Jing-Bo
影响因子：
37.8
作者：
Napp, Andreas;Joosten, Stephan;Silny, Jiri
通讯作者：
Silny, Jiri
DOI：
10.1093/europace/euy155
发表时间：
2019-02-01
期刊：
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
影响因子：
--
作者：
Driessen S;Napp A;Schmiedchen K;Kraus T;Stunder D
通讯作者：
Stunder D
影响因子：
158.5
作者：
Russo, Robert J.;Costa, Heather S.;Wolff, Steven D.
通讯作者：
Wolff, Steven D.