Division of Cardiac Surgery, Thomas Jefferson University Hospital, 1025 Walnut St, Suite 607, Philadelphia, PA, USA.
Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
J Interv Card Electrophysiol. 2021 Jun;61(1):1-10. doi: 10.1007/s10840-020-00930-8. Epub 2021 Jan 12.
Many patients with continuous-flow left ventricular assist devices (CF-LVAD) have other, co-existing implantable cardiac devices. While such devices often function appropriately, there is potential for electromagnetic interference (EMI). A literature review was performed to identify cases of EMI between CF-LVAD and other implanted cardiac devices to better understand their etiology, outcomes, and the strategies used to overcome such interference. The cases identified included interference between CF-LVAD and pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy. The EMI reported in the current literature can be broken down into two general categories: interference leading to difficulty establishing telemetry and interference leading to impaired electrical signal sensing. Such interference led to inappropriate shock delivery in some cases. The type of interference, and thus treatments, differed and were device dependent. The strategies employed to reduce interference included metal shielding, physical manipulation to increase the distance between devices, and even exchange of the implanted device with another brand of the same class. To avoid such EMI in the future, physicians must be aware of the reported interference between certain devices, and manufacturers must work more closely to increase the compatibility of implanted cardiac devices.
许多接受左心室辅助装置（CF-LVAD）连续流动治疗的患者都有其他共存的可植入心脏设备。虽然这些设备通常能正常工作，但存在电磁干扰（EMI）的潜在风险。我们进行了文献回顾，以确定 CF-LVAD 与其他植入式心脏设备之间 EMI 的案例，以更好地了解其病因、结果以及克服此类干扰的策略。确定的案例包括 CF-LVAD 与起搏器、植入式心脏复律除颤器和心脏再同步治疗之间的干扰。当前文献中报告的 EMI 可分为两类：导致遥测困难的干扰和导致电信号感应受损的干扰。这种干扰导致一些情况下出现不适当的电击治疗。干扰的类型，以及因此的治疗方法，因设备而异。为了减少干扰而采用的策略包括金属屏蔽、物理操作以增加设备之间的距离，甚至更换为同一类别的另一种品牌的植入设备。为了避免未来出现这种 EMI，医生必须了解某些设备之间报告的干扰，制造商必须更加密切地合作，以提高植入式心脏设备的兼容性。
