Electromagnetic Interference

OVERVIEW

electromagnetic interference can affect the function of implanted eletronic devices such as pacemakers and ICDs

CAUSES

EFFECTS ON PACEMAKERS AND ICDs

PREVENTION

use bipolar diathermy
if conventional diathermy required → position plate so that most of current passes away from the pacemaker, use short, sharp bursts and watch SpO2 or art line.
ensure all devices are not in the same vector as the pacemaker current (between pacemaker and heart)
if reason for pacemaker severe heart failure where loss of AV synchrony may precipitate haemodynamic compromise -> have a telemetric programmer and cardiac technician close @ hand
keep lithotripter atleast 6 inches away from pacemaker (should be timed with ECG and rate modulation deactivated)
if have to defibrillate keep pads as far from pace maker as possible
avoid sux c/o faciculations (if used in a patient with a sensing mode activated -> use defaciculating dose of NDNMBD)
avoid using defibrillation if at all possible (high level of EMI) -> if required use AP pad configuration and keep pad’s 10cm away from pacemaker

MAGNETS

no longer recommended to place magnet over pacemakers, only applicable to older non-reprogrammable pacemakers
placement of a magnet would default mode to an asynchronous mode or a fixed rate
all modern pacemakers are reprogrammable

MANAGEMENT OF PACEMAKER MALFUNCTION