Geppert A, Rauscha F
Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Wien, Osterreich.
Wien Klin Wochenschr. 2001 Jan 15;113(1-2):15-26.
Lead dysfunction is still the predominant cause of pacemaker dysfunction. Beyond lead dysfunction clinicians might encounter problems resulting from the surgical procedure of pacemaker implantation, from specific programmable pacemaker functions (e.g. undersensing of premature ventricular complexes when autosensing is activated) and from interference with electromagnetic fields. Electromagnetic interference between pacemakers and mobile phones has been demonstrated both in vitro and in vivo, but in daily life pacemaker patients can readily use mobile phones when certain security measures are taken into account. Electromagnetic interference between anti-theft devices and pacemakers can arise from situations where the pacemaker is in close proximity to the anti-theft device, but in daily life these interferences are rare. The electromagnetic fields generated during magnetic resonance imaging (MRI) are considerably stronger than those generated by mobile phones or anti-theft devices, therefore permanent pacemakers are still considered a contraindication for MRI, although several case reports have recently been published that reported on uneventful MRI procedures in pacemaker patients. The present review summarizes the current knowledge on the most frequent pacemaker dysfunctions and electromagnetic interferences that might be relevant in clinical practice.
导线功能障碍仍然是起搏器功能障碍的主要原因。除导线功能障碍外，临床医生还可能遇到因起搏器植入手术、特定的可编程起搏器功能（如激活自动感知功能时对室性早搏的感知不足）以及电磁场干扰而产生的问题。起搏器与手机之间的电磁干扰已在体外和体内得到证实，但在日常生活中，只要采取某些安全措施，起搏器患者可以随时使用手机。当起搏器靠近防盗装置时，防盗装置与起搏器之间可能会产生电磁干扰，但在日常生活中，这种干扰很少见。磁共振成像（MRI）过程中产生的电磁场比手机或防盗装置产生的电磁场要强得多，因此永久性起搏器仍然被视为MRI的禁忌症，尽管最近有几篇病例报告称起搏器患者在MRI检查过程中未出现异常情况。本综述总结了目前关于临床实践中可能相关的最常见起搏器功能障碍和电磁干扰的知识。
