Huang Jing, Lin Kaibin, Lu Wu, Ding Ranran, Wu Bingjie, Cai Mingqi, Nazarian Saman, Zhao Wenbin, Li Jingbo, Huang Dong
Department of Cardiology, Shanghai East Hospital, Shanghai Tongji University School of Medicine, Shanghai, China.
Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2020 Dec 23;7:607604. doi: 10.3389/fcvm.2020.607604. eCollection 2020.
The effect of transient electromagnetic fields on the function of pacemakers is not well-evaluated. There is a lack of effective methods for clinicians to reduce electromagnetic susceptibility (EMS) during implantation of pacemakers. This study aimed to evaluate whether a novel method of handling the excess leads in the pocket can lower the EMS of pacemakers and consequently reduce the effect of electromagnetic interference caused by transient electromagnetic fields on pacemakers. An chest model was established to simulate the clinical condition of dual-chamber pacemaker implantation. Three different intertwining patterns of excess leads were examined: parallel, twisted once, and multiple twisted-pair. Oscillated currents were injected into a copper electrical wire set horizontally above the model to create a radiated magnetic field to simulate the transient daily electromagnetic exposure of pacemakers. The electromagnetic induction of current was measured. The occurrence of EMS-related adverse events was evaluated when the induced pulsed voltage was applied. Transient electromagnetic fields can induce electromagnetic noise in the pacing loop and inhibit the release of pacing pulses. The multiple twisted-pair intertwining pattern of excess leads was associated with a lower induced voltage amplitude than both the parallel and once-twisted patterns ( < 0.001). Even once twisted could significantly reduce induced voltage amplitude compared to not twisted ( < 0.001). A lower incidence of pacing inhibition was also observed in the multiple twisted-pair group than in the other two groups ( < 0.001). Transient electromagnetic fields can cause pacing inhibition. Twisting the excess leads for multiple turns in the pocket is an effective method to reduce the EMS of the dual-chamber pacemaker.
瞬态电磁场对起搏器功能的影响尚未得到充分评估。临床医生在植入起搏器时缺乏有效的方法来降低电磁敏感性（EMS）。本研究旨在评估一种处理囊袋中多余导线的新方法是否能降低起搏器的EMS，从而减少瞬态电磁场对起搏器造成的电磁干扰影响。建立了一个胸部模型来模拟双腔起搏器植入的临床情况。研究了三种不同的多余导线缠绕方式：平行、单扭和多对扭绞。将振荡电流注入模型上方水平设置的铜质电线中，以产生辐射磁场，模拟起搏器日常的瞬态电磁暴露。测量电流的电磁感应。当施加感应脉冲电压时，评估与EMS相关的不良事件的发生情况。瞬态电磁场可在起搏环路中感应出电磁噪声并抑制起搏脉冲的释放。多余导线的多对扭绞缠绕方式与平行和单扭方式相比，感应电压幅度更低（<0.001）。与未扭绞相比，即使单扭也能显著降低感应电压幅度（<0.001）。多对扭绞组的起搏抑制发生率也低于其他两组（<0.001）。瞬态电磁场可导致起搏抑制。在囊袋中将多余导线多圈扭绞是降低双腔起搏器EMS的有效方法。
