Effects of extracorporeal shock wave lithotripsy on cardiac pacemakers and its safety in patients with implanted cardiac pacemakers.

摘要: UNLABELLED Effects of extracorporeal shock wave lithotripsy (ESWL) were studied on 15 pacemakers (standard single chamber n = 5, dual 6, rate responsive [Activitrax] 4). In-vitro testing involved suspending the in a bath degassified, deionized water firmly taped to platform at point maximal pressure, i.e., second focal (F2), where they received pressure shocks (means 1300) from HM3 Dornier lithotriptor. The pacemakers, programmed their most sensitive setting, continuously pacing nominal outputs (atrial and ventricular DDD mode). All units assessed by system analyzer before after study, then underwent destructive analysis. During standard (VVI) stimulus triggered ESWL. For devices, ESWL was atrial paced event which induced inhibition output two pacemaker. This eliminated reprogramming less setting. pacemaker can, hermetic seal internal circuitry undamaged all units. Two had activity sensing piezoelectric elements shattered when placed F2. other 5 cm F2 stimulated maximum upper with therapy, but otherwise unaffected. Subsequent this six patients VVI (five), (one) modes implanted thorax successful without or arrhythmic event. CONCLUSIONS (A) It is generally safe for devices application undergo modifying pacing/sensing parameters. (B) Patients who pace atrium should be reprogrammed mode during (C) have feature off and, if abdomen, probably not