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Related Experiment Video

Updated: Jan 25, 2026

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
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Influence of electrical stimulation therapy on permanent pacemaker function.

Florian Egger1, Christian Hofer2, Fabian P Hammerle3

  • 13rd Medical Department with Cardiology, Chest Pain Unit and Intensive Care Medicine, Wilhelminenspital, Montleartstraße 37, 1160, Vienna, Austria. dr_egger@icloud.com.

Wiener Klinische Wochenschrift
|April 27, 2019
PubMed
Summary
This summary is machine-generated.

Electrical stimulation therapy (EST) can interfere with permanent pacemakers (PM), particularly with bilateral electrode placement. However, unilateral EST application demonstrated safety across all tested configurations in a simulation study.

Keywords:
Chronic painDevice interactionEx-vivoFull-size modelTranscutaneous electrical neuromuscular stimulation

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Area of Science:

  • Biomedical Engineering
  • Electrophysiology
  • Pain Management

Background:

  • Electrical stimulation therapy (EST) and TENS are common pain treatments.
  • Increasing pacemaker (PM) use raises concerns about EST interference.
  • Conflicting guidelines exist for EST use in PM patients.

Purpose of the Study:

  • To evaluate the impact of electrical stimulation therapy (EST) on permanent pacemaker (PM) function.
  • To assess safety and potential interference of EST with PM devices.

Main Methods:

  • Used a full-scale human body electrical model to simulate EST on PM devices.
  • Evaluated various configurations of stimulation energy, electrode position, and PM models.
  • Analyzed intracardiac electrograms (iEGM) for signs of EST interference.

Main Results:

  • Unilateral EST application showed no interference with PM function in 700 configurations (0%).
  • Bilateral EST stimulation (350 configurations) resulted in ventricular inhibition or backup pacing in 47.1% of cases (165/350).
  • Interference during bilateral stimulation depended on specific stimulation parameters.

Conclusions:

  • EST may interfere with PM function, especially with bilateral electrode placement.
  • Unilateral EST application appears safe for PM patients in tested configurations.
  • Careful consideration of electrode placement is crucial when using EST in patients with pacemakers.