Effects of medically generated electromagnetic interference from medical devices on cardiac implantable electronic devices: A review

Table 1 Internal and external device interaction with permanent pacemakers / defibrillators

	Erquo et al[8], 2018	Pfeffer et al[9], 2016	Obwegeser et al[10], 2001	Shenoy et al[15], 2017	Singh et al[14], 2018	Schimpf et al[12], 2003
Internal/ External Device	St. Jude; CRT-D	Boston Scientific; S-ICD	Medtronic dual chamber ICD	Durata dual chamber ICD	Boston Scientific; S-ICD;	Medtronic dual chamber ICD
EMI Source	LVAD (pump exchange)	LVAD placement	Thalamic DBS	TENS unit (unreported location)	TENS unit on neck, back, axilla	T11 SCS
Adverse Interaction	Ventricular oversensing leading to inhibition of pacing	Oversensing leading to 31 ICD shocks	None	EMI leading to ICD shock	EMI leading to ICD shock	None
Therapeutic intervention	Turning off low-frequency attenuation filter	Transvenous ICD placement	N/A	Avoiding TENS units	Avoiding TENS units	N/A

PPM: Permanent pacemaker; LVAD: Left ventricular assist device; ICD: Implantable cardioverter-defibrillator; CRT-D: Cardiac resynchronization therapy defibrillator; S-ICD: Subcutaneous implantable cardioverter-defibrillator; DBS: Deep brain stimulator; N/A: Not applicable; TENS: Transcutaneous electrical nerve stimulation; SCS: Spinal cord stimulator.

Table 2 Device interaction on pacemaker and defibrillators

Type of device	Pacemaker	Defibrillators
LVADs	+	+
SCS	-	-
DBS	-	-
TENS	+	+

(-): No EMI noted; (+): EMI noted. LVAD: Left ventricular assist device; DBS: Deep brain stimulator; TENS: Transcutaneous electrical nerve stimulation; SCS: Spinal cord stimulator.

Table 3 Suggested cardiac implantable electronic devices peri-procedural management

Procedure	CIED (PPM)	CIED (ICD)
Endoscopy	Asynchronous	R or Magnet
APC	Asynchronous	R or Magnet
ENB	b	b
Electrocautery	Asynchronous	R or Magnet

APC: Argon plasma coagulation; ENB: Electromagnetic navigational bronchoscopy; b: Contraindicated; R: Reprogramming; CIED: Cardiac implantable electronic devices; PPM: Peri-procedural management; ICD: Implantable cardioverter defibrillators.