When cardiac resynchronization therapy isn't.
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Atrial Function↗
Biomedical subjects
Alan D Bernstein
Publications and source records attributed to Alan D Bernstein.
Do induction cooktops interfere with cardiac pacemakers?
AIMS: In induction cooktops, coils produce time-varying magnetic fields that induce eddy currents in the ferromagnetic bottom of a pot or pan, thereby heating it, while the cooktop itself remains cool. Interference with pacemaker sensing could conceivably be produced by voltages induced directly by induction or indirectly by leakage currents. METHODS AND RESULTS: A worst-case pacemaker-patient (PP) model representing left-sided implantation of a unipolar pacemaker was used for measurement of induced voltages, to judge whether induction cooktops could interfere with pacemaker sensing. Eleven induction cooktops of European manufacture were tested using the PP model. The pacemaker sensitivity with respect to 24 kHz voltages, amplitude-modulated at 100 Hz, was investigated in 244 devices. The current passing through the body of a grounded patient touching a metal pot was determined by measuring the voltage from hand to hand and between electrodes placed on the thorax to simulate an implanted unipolar pacing system underneath. The results obtained were complex. If the pot is positioned concentrically with the induction coil, the smallest pot produced the largest stray field, but the induced voltage always remained below the critical value of 100 mV. With eccentrically positioned large pots, voltages of up to 800 mV could be induced. The induced voltage could always be reduced to </=60 mV by maintaining a distance of 35 cm. The most sensitive pacemaker reacted at 90.5 mV. Because of leakage current, approximately 2% of the voltage between pot and ground appears across the pacemaker's sensing input. CONCLUSION: Patients are at risk if the implant is unipolar and left-sided, if they stand as close as possible to the induction cooktop, and if the pot is not concentric with the induction coil. Unipolar pacing systems can sense interference generated by leakage currents if the patient touches the pot for a long period of time. The most likely response to interference is switching to an asynchronous interference mode. Patients with unipolar pacemakers are at risk only if they are not pacemaker-dependent.
Adult↗
The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. North American Society of Pacing and Electrophysiology/British Pacing and Electrophysiology Group.
In light of evolving pacemaker technology and increasing interest in multisite pacing, the Committee on the Development of Position Statements (CDPS) of the North American Society of Pacing and Electrophysiology (NASPE) created an ad hoc Pacemaker Mode Code Task Force in April 2001 under the chairmanship of David L. Hayes, MD, for the purpose of bringing the NASPE/British Pacing and Electrophysiology Group (BPEG) Generic Pacemaker Code (NBG Code) up to date. The task force, whose members are the authors of this article, designed a revised NBG Code in which three major issues were taken into account. First, it was recognized that all modern pacemakerpulse generators are capable of extensive bidirectional communication with an external programming device, making them "communicating" pulse generators as defined by the current (1987) NBG Code. Second, it was decided that a means of providing basic information regarding the location of multisite pacing would be a useful ingredient of the NBG Code. Third, in view of the extensive antibradycardia pacing capabilities common in modern implantable cardioverter defibrillators and the availability of the NASPE/BPEG Defibrillator Code (NBD Code), it was considered unnecessary for the NBG Code to address the presence or absence of antitachycardia features. The resulting updated version of the NBG Code as described herein was endorsed by the BPEG on September 20, 2001 and adopted by the NASPE Board of Trustees on October 18, 2001. The structure of the revised NBG Code differs from that of the previous version in two respects alone: Position IV specifies only the presence or absence of rate modulation, and Position V specifies only the location or absence of multisite pacing (i.e., biatrial or biventricular pacing with at least two stimulation sites in each case) more than one stimulation site in any single cardiac chamber, or any combination of these. The revised NBG Code is deliberately configured to avoid confusion with earlier mode codes, and it is the authors' hope that it will serve as an enhanced resource for communication among those engaged in every phase of the multidisciplinary practice of cardiac rhythm management.
Bradycardia↗