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Thermal Measurement Techniques in Analytical Microfluidic Devices
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[Device-device interaction].

Victoria Johnson1,2, Christian W Hamm3, Jörn Schmitt3

  • 1Med. Klinik I, Abteilung für Kardiologie und Angiologie, Universitätsklinik Gießen, UKGM, Klinikstraße 33, 35392, Gießen, Deutschland. Victoria.Johnson@innere.med.uni-giessen.de.

Herzschrittmachertherapie & Elektrophysiologie
|April 17, 2019
PubMed
Summary
This summary is machine-generated.

Interactions between cardiac implantable electronic devices (CIEDs) can be life-threatening. Proper pacemaker programming can prevent dangerous interactions with devices like wearable cardioverter defibrillators (WCDs) and subcutaneous ICDs (S-ICDs).

Keywords:
Chronic heart failureImplantable cardioverter defibrillatorInappropriate ICD shockOversensingPacemaker

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Increasing use of cardiac implantable electronic devices (CIEDs), including pacemakers (PM), implantable cardioverter defibrillators (ICDs), and devices for heart failure.
  • Potential for device-device interactions, which can lead to severe patient outcomes, including death.
  • Limited scientific studies and case reports due to low patient numbers.

Purpose of the Study:

  • To investigate potential device-device interactions among various CIEDs.
  • To identify specific CIEDs at risk for interaction with previously implanted pacemakers.
  • To propose strategies for mitigating identified risks.

Main Methods:

  • Analysis of device algorithms and potential interference sources, particularly electrocardiogram (ECG) signal interpretation.
  • Focus on wearable cardioverter defibrillators (WCDs) and subcutaneous ICDs (S-ICDs) due to their reliance on surface ECG.
  • Review of clinical observations and device programming considerations.

Main Results:

  • Wearable cardioverter defibrillators (WCDs) and subcutaneous ICDs (S-ICDs) pose a risk of interaction with pacemakers due to surface ECG algorithms susceptible to pacemaker stimulation artifacts.
  • Correct programming of pacemakers in bipolar stimulation mode can prevent ECG artifacts and inadequate device treatment.
  • Baroreceptor activation therapy (BAT) and cardiac contractility modulation (CCM) systems have not shown reported interactions, despite ECG artifact generation, though further trials are needed for CCM.

Conclusions:

  • Pacemaker programming is crucial for preventing adverse interactions with WCDs and S-ICDs.
  • While BAT and CCM show no current interaction issues, ongoing vigilance and research are necessary.
  • Proactive management and understanding of CIED interactions are vital for patient safety.