Shockwave lithotripsy and pacemakers: experience with 20 cases

Area of Science:

• Urology
• Cardiology
• Biomedical Engineering

Background:

• Historically, patients with cardiac pacemakers were excluded from extracorporeal shock wave lithotripsy (SWL).
• Advancements in research and clinical practice have led to re-evaluating this exclusion criterion.
• Recent studies indicate that SWL may be a viable option for select patients with pacemakers.

Purpose of the Study:

• To assess the safety and efficacy of SWL in patients with cardiac pacemakers.
• To identify necessary precautions for performing SWL in this patient population.
• To evaluate the incidence of cardiovascular events during SWL in pacemaker patients.

Main Methods:

• A retrospective analysis of 20 patients with various pacemaker types who underwent SWL.
• Pre-procedure cardiological evaluation and pacemaker reprogramming (dual-chamber to single-chamber mode, rate-responsive to VVI mode).
• Monitoring for cardiovascular events during and after SWL treatment.

Main Results:

• Successful SWL treatment in 20 patients with pacemakers.
• No significant cardiovascular events were reported during the treatment sessions.
• Pacemaker reprogramming and maintaining a distance of at least 5 cm from the blast path were crucial.

Conclusions:

• Extracorporeal shock wave lithotripsy (SWL) can be safely performed in most patients with pacemakers.
• Essential precautions include thorough cardiological evaluation and specific pacemaker reprogramming.
• Careful monitoring during SWL is vital for patient safety.