LaBan M M, Petty D, Hauser A M, Taylor R S
Department of PM&R, William Beaumont Hospital, Royal Oak, MI 48072.
Arch Phys Med Rehabil. 1988 May;69(5):358-62.
External electromagnetic interference with cardiac pacemaker function is a recognized hazard of electronic instrumentation used for diagnosis or therapy. Although improved shielding and circuitry have made newer pacemakers less vulnerable to extraneous electronic artifact, their increasing use may expose more patients to the complications of electromagnetic interference. The effects of nerve conduction stimulation testing (NCST) on patients with cardiac pacemakers were evaluated both clinically and in the laboratory. Estimates of interference potentials likely to occur at a pacemaker input during NCST were made by making calculations from a theoretical model. For three different pacemakers, these estimates were compared to laboratory tests of sensitivity to interference. Some potential for pacemaker interference was shown to exist, although primarily with unipolar pacing leads. Twenty patients, five of whom were monitored electrocardiographically, underwent uneventful nerve conduction studies. Although pulse producing stimulators have the potential to affect demand type pacemakers, if current paths are confined within standard clinical parameters, untoward responses appear unlikely.
外部电磁干扰对心脏起搏器功能的影响是用于诊断或治疗的电子仪器公认的风险。尽管改进的屏蔽和电路设计使新型起搏器对外来电子伪影的敏感度降低，但起搏器使用的增加可能会使更多患者面临电磁干扰并发症的风险。本研究从临床和实验室两方面评估了神经传导刺激测试（NCST）对植入心脏起搏器患者的影响。通过理论模型计算，估计了NCST期间起搏器输入端可能出现的干扰电位。针对三种不同的起搏器，将这些估计值与干扰敏感度的实验室测试结果进行了比较。结果显示，尽管主要是单极起搏导线存在起搏器干扰的可能性，但仍有一定干扰风险。20名患者接受了顺利的神经传导研究，其中5名患者进行了心电图监测。尽管产生脉冲的刺激器有可能影响按需型起搏器，但如果电流路径限制在标准临床参数范围内，则不太可能出现不良反应。
