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Electric and Magnetic Field Devices for Stimulation of Biological Tissues
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An unusual source of electromagnetic interference: a device-device interaction.

Marcin Kowalski1, Richard K Shepard, Gautham Kalahasty

  • 1Virginia Commonwealth University School of Medicine, Division of Cardiology, Richmond, Virginia, USA.

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Summary

Electrosurgical generators can interfere with implantable cardioverter-defibrillator (ICD) high-voltage impedance measurements. Awareness of electromagnetic interference (EMI) sources is crucial to prevent unnecessary device replacement.

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Implantable cardioverter-defibrillators (ICDs) can experience oversensing due to electromagnetic interference (EMI).
  • This case highlights an unusual EMI source affecting only the high-voltage (HV) impedance measurement of a specific ICD model.

Observation:

  • A Boston Scientific Teligen 100 ICD showed erroneous HV impedance readings (<20-40 Ohms) and noise after implantation.
  • Replacing the lead and generator did not resolve the issue, indicating an external interference source.

Findings:

  • The interference stemmed from an electrosurgical generator's electrocautery patch placed near the ICD generator.
  • Low-amplitude current from the electrosurgical device's monitoring system interfered with the ICD's HV impedance measurement.
  • Other ICD models (Medtronic Virtuoso, St. Jude Medical Current DR) were unaffected due to higher current output for impedance measurement.

Implications:

  • Clinicians must be aware of potential EMI sources, including electrosurgical devices.
  • Failure to identify EMI can lead to misdiagnosis and unnecessary replacement of ICD pulse generators.
  • Proper patient evaluation and awareness of device interactions are essential for safe ICD management.