Department of Cardiology, Erasmus MC University Medical Center, Room RG 431, Dr Molewaterplein 40, Rotterdam, The Netherlands.
Department of Cardio-thoracic Surgery, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.
Europace. 2020 Apr 1;22(4):584-587. doi: 10.1093/europace/euaa006.
To investigate the prevalence of electromagnetic interference (EMI) between left ventricular assist devices (LVADs) and implantable cardioverter-defibrillators (ICDs)/pacemakers (PMs).
A retrospective single-centre study was conducted, including all patients undergoing HeartMate II (HMII) and HeartMate 3 (HM3) LVAD implantation (n = 106). Electromagnetic interference was determined by the inability to interrogate the ICD/PM. Overall, 85 (mean age 59 ± 8, 79% male) patients had an ICD/PM at the time of LVAD implantation; 46 patients with HMII and 40 patients with HM3. Among the 85 LVAD patients with an ICD's/PM's, 11 patients (13%) experienced EMI; 6 patients (15%) with an HMII and 5 patients (11%) with an HM3 (P = 0.59). Electromagnetic interference from the HMII LVADs was only present in patients with a St Jude/Abbott device; 6 of the 23 St Jude/Abbott devices. However, in the HM3 patients, EMI was mainly present in patients with Biotronik devices: 4 of the 18 with only one (1/25) patient with a Medtronic device. While initial interrogation of these devices was not successful, none of the 11 cases experienced pacing inhibition or inappropriate shocks.
In summary, the prevalence of EMI between ICDs in the older and newer type of LVAD's remains rather high. While HMII patients experienced EMI with a St Jude/Abbott device (which was already known), HM3 LVAD patients experience EMI mainly with Biotronik devices. Prospective follow-up, preferably in large registries, is warranted to investigate the overall prevalence and impact of EMI in LVAD patients.
研究左心室辅助装置（LVAD）与植入式心脏复律除颤器（ICD）/起搏器（PM）之间电磁干扰（EMI）的发生率。
进行了一项回顾性单中心研究，包括所有接受 HeartMate II（HMII）和 HeartMate 3（HM3）LVAD 植入的患者（n=106）。通过无法对 ICD/PM 进行询问来确定 EMI。总体而言，85 例（平均年龄 59±8 岁，79%为男性）患者在 LVAD 植入时带有 ICD/PM；其中 46 例为 HMII，40 例为 HM3。在 85 例带有 ICD/PM 的 LVAD 患者中，有 11 例（13%）发生 EMI；6 例（15%）来自 HMII，5 例（11%）来自 HM3（P=0.59）。HMII LVAD 的 EMI 仅存在于带有 St Jude/Abbott 设备的患者中；23 例 St Jude/Abbott 设备中有 6 例。然而，在 HM3 患者中，EMI 主要存在于带有 Biotronik 设备的患者中：18 例中有 4 例，只有 1 例（1/25）患者带有 Medtronic 设备。虽然最初对这些设备的询问不成功，但没有 11 例患者出现起搏抑制或不适当的电击。
总的来说，在较新和较旧类型的 LVAD 中，ICD 之间 EMI 的发生率仍然相当高。虽然 HMII 患者因 St Jude/Abbott 设备发生 EMI（这是已知的），但 HM3 LVAD 患者主要因 Biotronik 设备发生 EMI。需要前瞻性随访，最好在大型注册研究中，以调查 EMI 在 LVAD 患者中的总体发生率和影响。
