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电子商品防盗系统触发起搏器和植入式心律转复除颤器的研究(SPICED TEAS)

Study of Pacemaker and Implantable Cardioverter Defibrillator Triggering by Electronic Article Surveillance Devices (SPICED TEAS).

作者信息

McIvor M E, Reddinger J, Floden E, Sheppard R C

机构信息

Research Section, Heart Institute of St. Petersburg, Florida 33701, USA.

出版信息

Pacing Clin Electrophysiol. 1998 Oct;21(10):1847-61. doi: 10.1111/j.1540-8159.1998.tb00002.x.

DOI:10.1111/j.1540-8159.1998.tb00002.x
PMID:9793079
Abstract

The magnetic fields emitted by electronic article surveillance (EAS) systems (shoplifting gates) are a source of interference for implanted medical devices. In the Study of Pacemaker and Implantable Cardioverter Defibrillator Triggering by Electronic Article Surveillance Devices (SPICED TEAS), 25 adult volunteers with ICDs and 50 with pacemakers were exposed to the fields of six different EAS systems. These EAS systems used three modes of operation: magnetic audio frequency, swept radiofrequency, and acoustomagnetic technology. No ICD exhibited interference mimicking sensing of tachyarrhythmias with any EAS system. Pacemakers interacted variably, depending on the type of EAS system. Swept radiofrequency systems produced no interaction with any implanted medical device. One magnetic audio frequency system interacted with 2 of 50 pacemakers. The acoustomagnetic system interacted with 48 of 50 pacemakers. Interactions included asynchronous pacing, atrial oversensing (producing "EAS induced tachycardia" in the ventricle), ventricular oversensing (with pacemaker inhibition), and paced beats resulting from the direct induction of current in the pacemaker ("EAS induced pacing"). These interactions produced symptoms in some patients (palpitations, presyncope) only while patients were in the EAS field. No pacemaker was reprogrammed. We conclude that high energy, pulsed low frequency EAS systems such as acoustomagnetic systems interfere with most pacemakers. Pacemaker patients should be advised to minimize exposure to the fields of such systems to prevent the possibility of serious clinical events.

摘要

电子商品防盗(EAS)系统(商场防盗门禁)发出的磁场是植入式医疗设备的干扰源。在“电子商品防盗设备对起搏器和植入式心脏复律除颤器触发作用的研究”(SPICED TEAS)中,25名植入植入式心脏复律除颤器(ICD)的成年志愿者和50名植入起搏器的成年志愿者暴露于六种不同EAS系统的磁场中。这些EAS系统采用三种操作模式:磁音频、扫频射频和声磁技术。没有ICD在任何EAS系统下出现模拟快速心律失常感知的干扰。起搏器的反应各不相同,这取决于EAS系统的类型。扫频射频系统与任何植入式医疗设备均无相互作用。一种磁音频系统与50台起搏器中的2台发生相互作用。声磁系统与50台起搏器中的48台发生相互作用。相互作用包括异步起搏、心房感知过度(在心室产生“EAS诱发的心动过速”)、心室感知过度(伴有起搏器抑制)以及起搏器中电流直接感应导致的起搏脉冲(“EAS诱发的起搏”)。这些相互作用仅在患者处于EAS磁场中时在一些患者身上产生症状(心悸、先兆晕厥)。没有起搏器被重新编程。我们得出结论,高能、脉冲低频EAS系统,如声磁系统,会干扰大多数起搏器。应建议植入起搏器的患者尽量减少暴露于此类系统的磁场中,以防止发生严重临床事件的可能性。

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