Marco D, Eisinger G, Hayes D L
Siemens Pacesetter, Sylmar, California.
Pacing Clin Electrophysiol. 1992 Nov;15(11 Pt 2):2016-22. doi: 10.1111/j.1540-8159.1992.tb03013.x.
A challenge for pacemaker therapists is whether a patient working in an environment with the potential for electromagnetic interference (EMI) can return to their work after a pacemaker has been implanted. Common practice has been to prohibit pacemaker patients from using electric welding machines. Twelve work environments and a new method for monitoring the pacemaker rhythm in the presence of EMI were tested. The new method uses a special memory called the event record found in several Siemens Pacesetter pacemaker models. Surface ECGs with a marking system, intracardiac electrograms, and a digital monitor were used to verify the results with event records. The results from several sources of EMI are reported. Twenty-one in vivo and in vitro tests were performed in the work environments of 12 patients. Event records were useful and accurate both in vivo and in vitro. Electric are welding machines up to 225 A did not affect these pacemakers. Arc welding machines using 1,000 A or more inhibited the in vitro test system within 1 or 2 meters of the weld or power generator. Electric welding machines with high frequency voltage superimposed on the welding current affected the pacemaker when it was within 2 meters of the power unit and 1 meter of the weld. Very large industrial degaussing coils affected pacemakers within 2 meters. The test method using event records was found to be an effective addition to monitoring the pacemaker. These results are specific for the pacemaker models tested. Such testing allows the physician to make a knowledgeable decision regarding return to work for the pacemaker patient in a high EMI environment.
对于起搏器治疗师而言，一个挑战是，植入起搏器后的患者若在有可能产生电磁干扰（EMI）的环境中工作，能否重返工作岗位。通常的做法是禁止起搏器患者使用电焊机。对12种工作环境以及一种在存在电磁干扰时监测起搏器节律的新方法进行了测试。这种新方法使用了一种特殊的存储器，即事件记录，在几款西门子帕西起搏器型号中都能找到。利用带有标记系统的体表心电图、心内电图和数字监测仪，通过事件记录来验证结果。报告了几种电磁干扰源的结果。在12名患者的工作环境中进行了21次体内和体外测试。事件记录在体内和体外都很有用且准确。高达225安培的电焊机不会影响这些起搏器。使用1000安培或更高电流的弧焊机会在距离焊缝或发电机1至2米范围内抑制体外测试系统。在焊接电流上叠加高频电压的电焊机，当起搏器位于距电源装置2米以内且距焊缝1米以内时，会对其产生影响。非常大的工业消磁线圈会在2米范围内影响起搏器。结果发现，使用事件记录的测试方法是监测起搏器的一种有效补充。这些结果是针对所测试的起搏器型号而言的。此类测试能让医生就起搏器患者在高电磁干扰环境中重返工作岗位做出明智的决定。
