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首页> 外文期刊>Surgical Endoscopy >Electromagnetic interference on cardiac pacemakers and implantable cardioverter defibrillators during endoscopy as reported to the US Federal Drug Administration
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Electromagnetic interference on cardiac pacemakers and implantable cardioverter defibrillators during endoscopy as reported to the US Federal Drug Administration

机译：心脏起搏器的电磁干扰和内窥镜检查期间的可植入心脏去纤维蛋白（Ensocedcop）据报道，美国联邦药物管理局

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Introduction More than 3 million patients have a cardiac implanted electronic device (CIED) such as a pacemaker or implanted cardioverter-defibrillator in the USA. These devices are susceptible to electromagnetic interference (EMI) leading to malfunction and injury. Radiofrequency energy, the most common modality for obtaining hemostasis during endoscopy, is the most common source of EMI. Few studies have evaluated the effect of endoscopic radiofrequency energy on CIEDs. We aim to characterize CIED dysfunction related to endoscopic procedures. We hypothesize that EMI from endoscopic energy can result in patient injury. Methods We queried the Manufacturer and User Facility Device Experience (MAUDE) database for CIED dysfunction related to electrosurgical devices over a 10-year period (2009-2019). CIED dysfunction events were identified using seven problem codes (malfunction, electromagnetic interference, ambient noise, pacing problem, over-sensing, inappropriate shock, defibrillation). These were cross-referenced for the terms "cautery, electrocautery, endoscopy, esophagus, colonoscopy, colon, esophagoscopy, and esophagogastroduodenoscopy." Reports were individually reviewed to confirm and characterize CIED malfunction due to an endoscopic procedure. Results A search for CIED dysfunction resulted in 43,759 reports. Three hundred and eleven reports (0.7%) were associated with electrocautery, and of these, 45 reports (14.5%) included endoscopy. Ten reports involving endoscopy (22%) specified upper (3, 7%) or lower (7, 16%) endoscopy while the remainder were non-specific. Twenty-six of reports involving endoscopy (58%) suffered injury because of CIED dysfunction: Of these, 17 (65%) received inappropriate shocks, 5 (19%) had pacing inhibition with bradycardia or asystole, 3 (12%) had CIED damage requiring explant and replacement, and 1 (4%) patient suffered ventricular tachycardia requiring hospital admission. Conclusion The use of energy during endoscopy can cause dysfunction of CIEDs. This most commonly results in inappropriate defibrillation, symptomatic bradycardia, and asystole. Patients with CIEDs undergoing endoscopy should undergo pre- and post-procedure device interrogation and re-programming to avoid patient injury.
机译：导言在美国，超过300万名患者有心脏植入电子设备（CIED），如起搏器或植入心脏复律除颤器。这些设备容易受到电磁干扰（EMI）的影响，从而导致故障和伤害。射频能量是内窥镜检查中最常见的止血方式，也是最常见的电磁干扰源。很少有研究评估内镜射频能量对CIED的影响。我们的目的是描述与内镜手术相关的CIED功能障碍。我们假设来自内窥镜能量的EMI会导致患者受伤。方法我们查询制造商和用户设施设备体验（MAUDE）数据库，了解10年（2009-2019）期间与电外科设备相关的CIED功能障碍。使用七个问题代码（故障、电磁干扰、环境噪声、起搏问题、过度感知、不当电击、除颤）识别CIED功能障碍事件。术语“烧灼术、电灼术、内窥镜检查、食道检查、结肠镜检查、结肠检查、食道镜检查和食道胃十二指肠镜检查”相互参照对报告进行单独审查，以确认和描述由于内窥镜手术导致的CIED故障。结果共有43759例CIED功能障碍报告。311份报告（0.7%）与电烙术有关，其中45份报告（14.5%）包括内窥镜检查。10份涉及内窥镜检查的报告（22%）指定了较高（3,7%）或较低（7,16%）的内窥镜检查，而其余报告为非特异性。26例涉及内窥镜检查的报告（58%）因CIED功能障碍而受伤：其中17例（65%）接受了不适当的电击，5例（19%）因心动过缓或心脏停搏而出现起搏抑制，3例（12%）CIED损伤需要切除和更换，1例（4%）室性心动过速需要住院。结论内镜检查过程中能量的使用会导致CIEDs功能障碍。这通常会导致不适当的除颤、症状性心动过缓和心脏停搏。接受内窥镜检查的CIED患者应在手术前后接受设备询问和重新编程，以避免患者受伤。

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