• Safety and Health at Work
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• 제4권3호
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• pp.156-159
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• 2013

Background: Cardiac pacemakers are known to be susceptible to strong electromagnetic fields (EMFs). This in vivo study investigated occurrence of electromagnetic interference with pacemakers caused by common environmental sources of EMFs. Methods: Eleven volunteers with a pacemaker were exposed to EMFs produced by two mobile phone base stations, an electrically powered commuter train, and an overhead high voltage transmission lines. All the pacemakers were programmed in normal clinically selected settings with bipolar sensing and pacing configurations. Results: None of the pacemakers experienced interference in any of these exposure situations. However, often it is not clear whether or not strong EMFs exist in various work environments, and hence an individual risk assessment is needed. Conclusions: Modern pacemakers are well shielded against external EMFs, and workers with a pacemaker can most often return to their previous work after having a pacemaker implanted. However, an appropriate risk assessment is still necessary after the implantation of a pacemaker, a change of its generator, or major modification of its programming settings.

• 대한의용생체공학회:의공학회지
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• 제36권1호
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• pp.31-36
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• 2015

In this study, we evaluated the effects of static magnetic fields of earphones and headphones on pacemakers and implantable cardioverter defibrillators(ICDs). Five pacemakers and three ICDs were subjected to in-vitro test with three headphones which were an in-ear earphone, clip-on headphone, and closed-back headphone. Each implantable device was placed in close proximity(within 3 mm) to the ear-pad of each of the earphone and headphones for 3 min. As a result, no effects were observed on the pacemakers for the earphone and headphones during the test, but an effect was observed on one ICD for the clip-on and closed-back headphone during the test. When the ICD was placed in close proximity to the headphones, the ICD temporarily suspended functions of tachyarrhythmia detection and therapy. The effect was not observed in this study when the headphones were at least 2 cm from the ICD. Based on these findings, patients with ICDs should be advised to keep earphones and headphones at least 2 cm apart from their ICDs.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.753-756
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• 2005

In the cases of severe arrythmia and conduction failure, a permanent implanted pacemaker is considered an essential treatment modality with less complication rate, broad indications and low morbidity. However, some pacemakers needs to be removed or replaced due to infection, in need of a lead upgrade, elective replacement, conduction failure or insulation failure. The most common indication for pacemaker extraction is infection. Conservative treatments such as administration of intravenous antibiotics and limitation of debridement are not effective and the removal of the entire pacing system is considered to be the best approach to pacemaker pocket infection. Although a locking stylet, a laser sheath and other newer methods of transvenous lead extraction have been proven to be effective, all leads cannot be removed. Moreover, major complications such as, cardiac tamponade and respiratory arrest during leads extraction procedure should not be ignored. We experienced two cases of exposed pacemakers in the subclavicular region. After removing the pacemaker body, exposed proximal lead was pulled out and cut off. The end of remnant external insulation tube was tied to prevent infection propagation between external insulation tube and inner metalic coil. Wounds were covered by local flap coverage. No other problems were detected during the one-year follow-up. Since there are few reports on lead-preserving method of treating limited infection of exposed pacemakers, we would like to present our new method for treating exposed pacemakers.

• 전자공학회논문지
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• 제52권1호
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• pp.148-154
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• 2015

제 2세대 (2G) 휴대전화인 GSM (global system for mobile communication) 휴대전화는 pacemaker 및 ICD (implantable cardioverter defibrillator)의 기능에 영향을 미칠 수 있다고 보고가 되어 왔다. 이에 본 연구에서는 제 3세대 (3G) 휴대전화인 WCDMA (wideband code division multiple access) 휴대전화에서 방출되는 전자파가 pacemaker 및 ICD에 미치는 영향에 대해 알아보았다. 총 5개의 pacemaker 및 3개의 ICD를 대상으로 ECG simulator를 이용한 in-vitro 실험으로 진행하였다. 실제 WCDMA 휴대전화 대신 WCDMA 모듈 (평균 출력 : 0.25 W, 주파수 대역 : 1950 MHz)을 사용했다. WCDMA 모듈 전자파가 pacemaker 및 ICD에 미치는 영향을 평가하기 위해, 각 이식형 의료기기들을 WCDMA 모듈에 최대한 근접 (3 mm 이내) 시킨 후 5분간 전자파에 노출 시켰다. 실험 결과 WCDMA 모듈 전자파가 5개의 pacemaker 및 3개의 ICD에 미친 어떠한 영향도 관찰 할 수 없었다. WCDMA 휴대전화는 GSM 휴대전화보다 더 높은 주파수 대역 (1800-2200 MHz)에서 더 낮은 출력(0.01-0.25 W)을 방출하기 때문에, WCDMA 휴대전화에서 발생하는 전자파는 pacemaker 및 ICD 기기들에게 영향을 미치지 않을 것으로 사료된다.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 1999년도 하계종합학술대회 논문집
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• pp.1063-1066
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• 1999

The delay of cardiac depolarization wave detection in the conventional pacemakers or AICD (automatic implantable cardioverter/ defibrillator, or ICD) has been overlooked. However, it is known that the delay may cause hemodynamic problems and may prevent the proper operation of a new automatic feature, automatic capture verification, that is to be appeared in the near-future devices. In order to reduce the effects of the delay, a delay prevention algorithm was developed and tested by applying three human electrograms. The algorithm set the sensing threshold just above the measured noise level to reduce the detection delay. It is found that the low threshold was able to reduce the delay by 20msec(average) In most cases. The implementation results showed reliability and efficacy of the algorithm, and the algorithm could be applicable to the existing hardware and software of the conventional pacemakers and AICD without any significant modifications.

• 중환자간호학회지
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• 제11권3호
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• pp.23-34
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• 2018

Purpose : This study develops a substantive theory on the recipients' experience of adapting to a permanent pacemaker. Method : The study used the grounded theory method developed by Strauss and Corbin (1998). The participants of the study were 13 adults who had received a permanent pacemaker during the previous year. The study addressed the research question "what is the experience of adaptation in people who had received permanent pacemakers?" From October 2016 to March 2017, data were collected from the participants through in-depth interviews. Results : The core category indicating the essence of the adaptation experience was shown to be "accepting the pacemaker as part of my body and living in line with it." Conclusions : In nursing practice, the results of this study will assist nurses in improving their communications with and developing guidelines or interventions for their clients who have received permanent pacemakers. In the field of nursing education, this study is expected to provide a framework to understand the experiences of future nurses and other healthcare workers working with permanent pacemaker recipients.

• Journal of Chest Surgery
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• 제16권4호
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• pp.547-554
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• 1983

Implantation of Dual Chamber Pacemakers Which sense in the Atrium and the Ventricle, and sequentially or synchronously trigger impulses in the both chambers, has led us to the near realization of the ideal "Physiologic Pacing". We have experienced two cases of implantation of Dual chamber pacemaker in September and October, 1983. One patient was a 21-year-old male who had postoperative complete heart block since he was taken Total correction of TOF in May, 1983 . We implanted transvenously a dual chamber pacemaker, VDD type, through the left subclavian vein. In the other patient who came to the emergency room for partial obstruction of small bowels with severe abdominal pain, nausea and vomiting, in whom heart block was found, we implanted a DDD type pacemaker through the left subclavian puncture. The pacemakers have been functioning well postoperatively for more than two months, and the conditions of patient were uneventful.

• 전기전자학회논문지
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• 제13권1호
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• pp.77-86
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• 2009

본 논문에서 이식형 심장 박동 조율기를 위한 심전도 검출기와 아날로그-디지털 변환기(ADC)를 설계한다. 제안한 웨이블렛 심전도 검출기는 웨이블렛 필터 뱅크 구조의 웨이블렛 변조기, 웨이블렛 합성된 심전도 신호의 가설 검정을 통한 QRS 신호 검출기와 0-교차점을 이용한 잡음 검출기로 구성된다. 저전력 소모의 동작을 유지하며 보다 높은 검출 정확도를 갖는 심전도 검출기의 구현을 위해, 다중스케일 곱의 알고리즘과 적응형의 임계값을 갖는 알고리즘을 사용하였다. 또한 심전도 검출기의 입력단에 위치하는 저전력 Successive Approximation Register ADC의 구현을 위해, 신호 변환의 주기 중, 매우 짧은 시간 동안에만 동작하는 비교기와 수동 소자로 구성되는 Sample&Hold를 사용하였다. 제안한 회로는 표준 CMOS $0.35{\mu}m$ 공정을 사용하여 집적 및 제작되었고, 99.32%의 높은 검출 정확도와 3V의 전원 전압에서 $19.02{\mu}W$의 매우 낮은 전력 소모를 갖는 것을 실험을 통해 확인하였다.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.42-47
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• 2017

Background Skin erosion is a dire complication of implantable cardiac pacemakers and defibrillators. Classical treatments involve removal of the entire generator and lead systems, however, these may result in fatal complications. In this study, we present our experience with a simplified salvage technique for exposed implantable cardiac electronic devices (ICEDs) without removing the implanted device, in an attempt to reduce the risks and complication rates associated with this condition. Methods The records of 10 patients who experienced direct ICED exposure between January 2012 and December 2015 were retrospectively reviewed. The following surgical procedure was performed in all patients: removal of skin erosion and capsule, creation of a new pocket at least 1.0-1.5 cm inferior to its original position, migration of the ICED to the new pocket, and insertion of closed-suction drainage. Patients with gross local sepsis or septicemia were excluded from this study. Results Seven patients had cardiac pacemakers and the other 3 had implantable cardiac defibrillators. The time from primary ICED placement to exposure ranged from 0.3 to 151 months (mean, 29 months. Postoperative follow-up in this series ranged from 8 to 31 months (mean follow-up, 22 months). Among the 10 patients, none presented with any signs of overt infection or cutaneous lesions, except 1 patient with hematoma on postoperative day 5. The hematoma was successfully treated by surgical removal and repositioning of the closed-suction drainage. Conclusions Based on our experience, salvage of exposed ICEDs is possible without removing the device in selected patients.

• Journal of Chest Surgery
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• 제51권5호
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• pp.363-366
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• 2018

One of the complications of permanent pacemaker implantation is unintended phrenic nerve stimulation. A 15-year-old boy with a permanent pacemaker presented with chest discomfort due to synchronous chest wall contraction with pacing beats. Even after reprogramming of the pacemaker, diaphragmatic stimulation persisted. Therefore, we performed thoracoscopic phrenic nerve insulation using a Gore-Tex patch to insulate the phrenic nerve from the wire. A minimally invasive approach using a thoracoscope is a feasible option for retractable phrenic nerve stimulation after pacemaker implantation.