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Sacral nerve neuromodulation in patients with cardiac pacemakers
Patricia A Wallace1, Felicia L Lane, Karen L Noblett
1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Orange, CA 92868, USA. pwallace@uci.edu
American Journal of Obstetrics and Gynecology
|July 10, 2007
Summary
Sacral nerve stimulation is safe for patients with cardiac pacemakers, effectively treating urinary urgency, frequency, and incontinence. This neuromodulation technique showed no interference with pacemakers in a small case series.
Area of Science:
- Urology
- Neuromodulation
- Cardiology
Background:
- Urinary urgency, frequency, and urge incontinence significantly impact quality of life.
- Sacral nerve stimulation (SNS) is an established treatment for refractory overactive bladder symptoms.
- The safety of SNS in patients with cardiac pacemakers requires careful consideration due to potential electromagnetic interference.
Observation:
- A case series involving 3 patients with cardiac pacemakers who underwent sacral nerve stimulation (SNS) for refractory urinary symptoms.
- Continuous cardiac monitoring during and after SNS lead placement and implantable pulse generator (IPG) implantation showed no cross-interference.
- Patients experienced a significant reduction in incontinence episodes during the SNS test phase.
Findings:
- Sacral nerve stimulation (SNS) demonstrated no detectable electromagnetic interference with cardiac pacemakers.
- All patients achieved a greater than 50% improvement in incontinence episodes.
- The InterStim system, including lead placement and IPG programming, was safely implemented.
Implications:
- Sacral nerve stimulation (SNS) is a viable and safe treatment option for patients with refractory urinary symptoms who also have cardiac pacemakers.
- This finding supports the expanded use of neuromodulation in complex patient populations.
- Further research with larger cohorts is warranted to confirm long-term safety and efficacy.
