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电击枪与现代可植入心脏起搏器

Electrical Stun Gun and Modern Implantable Cardiac Stimulators.

机构信息

1Italian National Institute of Health, Rome, Italy.

Italian National Institute of Health, Rome, Italy.

出版信息

Health Phys. 2019 Jan;116(1):18-26. doi: 10.1097/HP.0000000000000942.

Abstract

The aim of the study is to investigate systematically the possible interactions between two types of stun guns and last-generation pacemakers and implantable defibrillators. Experimental measurements were performed on pacemakers and implantable defibrillators from five leading manufacturers, considering the effect of stun gun dart positioning, sensing modality, stun gun shock duration, and defibrillation energy level. More than 300 measurements were collected. No damage or permanent malfunction was observed in either pacemakers or implantable defibrillators. During the stun gun shock, most of the pacemakers entered into the noise reversion mode. However, complete inhibition of the pacing activity was also observed in some of the pacemakers and in all the implantable defibrillators. In implantable defibrillators, standard stun gun shock (duration 5 s) caused the detection of a shockable rhythm and the start of a charging cycle. Prolonged stun gun shocks (10-15 s) triggered the inappropriate delivery of defibrillation therapy in all the implantable defibrillators tested. Also in this case, no damage or permanent malfunction was observed. For pacemakers, in most cases, the stun guns caused them either to switch to the noise reversion mode or to exhibit partial or total pacing inhibition. For implantable defibrillators, in all cases, the stun guns triggered a ventricular fibrillation event detection. No risks resulted when the stun gun was used by a person wearing a pacemaker or an implantable defibrillator. This work provides novel and up-to-date evidence useful for the evaluation of risks to pacemaker/implantable defibrillator wearers due to stun guns.

摘要

本研究旨在系统地研究两种电击枪与最新一代起搏器和植入式除颤器之间可能存在的相互作用。实验测量在五个主要制造商的起搏器和植入式除颤器上进行,考虑了电击枪飞镖定位、感应模式、电击枪电击持续时间和除颤能量水平的影响。共收集了 300 多次测量数据。在起搏器和植入式除颤器中,均未观察到任何损坏或永久性故障。在电击枪电击期间,大多数起搏器进入噪声反转模式。然而,在一些起搏器和所有植入式除颤器中,也观察到起搏活动完全抑制。在植入式除颤器中,标准电击枪电击(持续时间 5 秒)导致检测到可电击节律并开始充电周期。延长的电击枪电击(10-15 秒)在所有测试的植入式除颤器中引发了不适当的除颤治疗的实施。在这种情况下,也未观察到任何损坏或永久性故障。对于起搏器,在大多数情况下,电击枪要么使它们切换到噪声反转模式,要么导致部分或完全起搏抑制。对于植入式除颤器,在所有情况下,电击枪都会引发心室颤动事件的检测。当佩戴起搏器或植入式除颤器的人使用电击枪时,不会产生任何风险。这项工作提供了新颖和最新的证据,有助于评估电击枪对起搏器/植入式除颤器佩戴者的风险。

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