Lack of interference of electromagnetic navigation bronchoscopy to implanted cardioverter-defibrillator: in-vivo...

Electromagnetic navigation bronchoscopy (ENB) (Superdimension) is a diagnostic and therapeutic tool in patients with lung lesions. Very small data are available about potential interference of ENB magnetic field to implanted cardioverter-defibrillators (ICDs) and any documentation of ICD behaviour if a ventricular tachyarrhythmia occurs during ENB is lacking. We tested a number of selected ICDs to assess if any interference occurs by ENB magnetic field on detection of clinical ventricular fibrillation and shock delivery.

Thirteen patients undergoing an ICD implantation or elective replacement with a clinical indication to assess the efficacy of defibrillation underwent: (i) real-time telemetric recording from ICD during ENB activation to detect possible noise; (ii) defibrillation test during exposure to ENB board-generated magnetic field. All tested ICDs showed no noise detection at maximum sensitivity level. Induced ventricular fibrillation was correctly detected and cured by implanted device. No change in programmed ICD parameters was induced by exposure to ENB magnetic field.

All tested ICDs correctly operated and rescued the patients from induced ventricular fibrillation during ENB. Electromagnetic navigation bronchoscopy appears to be safe in heart patients with an ICD; however, close cardiac monitoring of these patients during ENB must be ensured as correct behaviour of all existing ICDs can only be presumed from compliance of the manufacturer to International Standards which establish procedures for electromagnetic interference checking on implantable devices on different ranges of frequency.