Maheshwari Kanwal R, Nikdel Kian, Guillaume Girard, Letra Ariadne M, Silva Renato M, Dorn Samuel O
Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, Texas.
Medtronics, Inc, Minneapolis, Minnesota.
J Endod. 2015 May;41(5):692-5. doi: 10.1016/j.joen.2014.12.011. Epub 2015 Feb 26.
The implantable cardioverter defibrillator (ICD) is an electronic device that emits electrical signals to the heart via lead wires and electrodes. It is used for cardiac rhythm monitoring and treatment. Because electronic dental devices have been shown to produce electromagnetic fields, we hypothesize that they may interfere with ICD function.
Nine dental devices (heat carrier, electronic apex locator, electric pulp tester, unipolar electrosurgery unit, electric motor, curing light, and 3 gutta-percha guns) were tested in this study for their ability to interfere with the function of 4 ICDs (2 single-chambered and 2 dual-chambered ICDs). ICD activity was monitored for 30 seconds using an ICD programmer (Medtronic 2090; Minneapolis, MN) and evaluated through an electrogram test strip printout.
Electromagnetic interference was detected with the electric motor, curing light, electric pulp tester, and electrosurgery unit although no electromagnetic disturbances were detected with these devices. No electromagnetic interferences were observed for the gutta-percha guns, heat carrier, and apex locator. However, the electrosurgery unit affected the dual-chambered ICD (Consulta CRT-D, Medtronic) and delivered therapies for fibrillation when no ventricular fibrillation was present.
Our results suggest that the electrosurgery unit produces electromagnetic disturbances with unwanted therapy delivery shock and potentially clinically significant outcomes.
植入式心脏除颤器(ICD)是一种通过导线和电极向心脏发射电信号的电子设备。它用于心脏节律监测和治疗。由于电子牙科设备已被证明会产生电磁场,我们推测它们可能会干扰ICD的功能。
本研究测试了九种牙科设备(热载体、电子根尖定位仪、牙髓电活力测试仪、单极电外科设备、电动马达、光固化灯和3把牙胶枪)干扰4台ICD(2台单腔ICD和2台双腔ICD)功能的能力。使用ICD编程器(美敦力2090;明尼阿波利斯,明尼苏达州)监测ICD活动30秒,并通过心电图测试条打印输出进行评估。
尽管这些设备未检测到电磁干扰,但电动马达、光固化灯、牙髓电活力测试仪和电外科设备检测到了电磁干扰。牙胶枪、热载体和根尖定位仪未观察到电磁干扰。然而,电外科设备影响了双腔ICD(美敦力公司的康素达CRT-D),并在不存在室颤时输送了治疗室颤的疗法。
我们的结果表明,电外科设备会产生电磁干扰,伴有不必要的治疗电击,并可能产生具有临床意义的结果。