New-generation lithotripters for treatment of patients with implantable cardioverter defibrillator: experimental approach and review of literature.
J Endourol
; 15(5): 479-84, 2001 Jun.
Article
en En
| MEDLINE
| ID: mdl-11465325
PURPOSE: The influence of shockwaves applied during extracorporeal shockwave lithotripsy on the function of implantable cardioverter defibrillators was evaluated. Mechanical influences as well as proper electrical function were tested in an experimental approach. MATERIALS AND METHODS: Two implantable defibrillators (Ventak Mini 1743 and AVII 1821) were exposed to the shockwaves of a new-generation lithotripter. Each of the antidysrhythmic devices was tested at several distances from and within the focus of the lithotripter. All studies were performed with maximum energy and the number of shockwaves used for stone treatment. The devices were connected to an ECG simulator, and continuous recording of a surface ECG, a shock ECG, and marker channel was performed. RESULTS: No macroscopic and microscopic mechanical damage was observed. The detection function of the implantable defibrillators was not altered by any electromagnetic artifacts even when brought into the focus of the shockwaves. All induced ventricular dysrhythmias were terminated properly regarding artifact sensing. However, after defibrillation, the pacing function of the Ventak Mini cardioverter defibrillator, which was programmed into the demand mode, failed. In this case, there was no post-shock pacing in the period of post-defibrillation asystole. The failure was caused by artifact oversensing. CONCLUSION: In patients with implanted cardiac devices undergoing treatment with a new-generation lithotripter, deactivation of the defibrillator is not mandatory. For safety reasons, continuous ECG recording is recommended. To avoid pacing failure by artifact oversensing, the shockwaves should be applied in a R-wave synchronous mode.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Litotricia
/
Desfibriladores Implantables
Tipo de estudio:
Evaluation_studies
Límite:
Humans
Idioma:
En
Revista:
J Endourol
Asunto de la revista:
UROLOGIA
Año:
2001
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Estados Unidos