The behavior of dual-chamber pacemakers exposed to a conducted low-frequency disruptive signal

This paper presents a study of the behavior of dual-chamber cardiac pacemakers submitted to low-frequency conducted disruptions. The disruptive signal is sinusoidal, operating at 50 Hz, 60 Hz, 10 kHz and 25 kHz. The behavior of the pacemakers is described by statistical data obtained with a telemetry system and by visualization of the pacemaker signal during the application of the interfering signal. The pacemakers were tested in two configurations. The first one consists of direct application of the interfering signal between the pacemaker terminals. In the second, these attempts are completed by in vitro tests using an electromagnetic model which allow us to take into account the interface which constitutes the human body. The pacemaker under test is inserted into a gelatine phantom mimicking the electrical conductivity of tissues. This study allowed us to define the pacemaker detection thresholds for the two test configurations. For the in vitro approach, which constitutes a complementary approach to a realistic implantation situation, oversensing is noticed for 10 kHz and 25 kHz interfering signal frequencies. Detection thresholds vary from a few tens to a few hundreds of mV, depending on the interfering signal frequency, the device and its programmed detection sensitivities.