• Safety and Health at Work
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• v.4 no.3
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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.

• Journal of Biomedical Engineering Research
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• v.36 no.1
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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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• v.32 no.6
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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.

• Journal of the Institute of Electronics and Information Engineers
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• v.52 no.1
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• pp.148-154
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• 2015

Reports show that global system for mobile communication (GSM) mobile phones, or two-generation (2G) mobile phones, could affect functions of pacemakers and implantable cardioverter defibrillators (ICDs). In this study, we evaluated the effects of radio frequency electromagnetic fields (RF-EMFs) emitted by wideband code division multiple access (WCDMA) mobile phones, which were third-generation (3G) mobile phones, on pacemakers and ICDs. Five pacemakers and three ICDs were subjected to in-vitro test using a ECG simulator. We used a WCDMA module (average power : 0.25 W, frequency band : 1950 MHz) instead of a real WCDMA mobile phone. To assess the effects of the WCDMA module on pacemakers and ICDs, each implantable device was placed in close proximity (within 3 mm) to the WCDMA module for 5 min. As a result, no effects were observed on the five pacemakers and three ICDs for the RF-EMFs emitted by the WCDMA module. Because WCDMA mobile phones have the higher frequency band (1800-2200 MHz) and lower power output (0.01-0.25 W) than GSM moboile phone, the RF-EMFs emitted by WCDMA mobile phones do not affect patients with pacemaker or ICD.

• Proceedings of the IEEK Conference
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• 1999.06a
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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.

• Journal of Korean Critical Care Nursing
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• v.11 no.3
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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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• v.16 no.4
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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.

• Journal of IKEEE
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• v.13 no.1
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• pp.77-86
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• 2009

A wavelet Electrocardiogram(ECG) detector and its analog-to-digital converter(ADC) for low-power implantable cardiac pacemakers are presented in this paper. The proposed wavelet-based ECG detector consists of a wavelet decomposer with wavelet filter banks, a QRS complex detector of hypothesis testing with wavelet-demodulated ECG signals, and a noise detector with zero-crossing points. To achieve high-detection performance with low-power consumption, the multi-scaled product algorithm and soft-threshold algorithm are efficiently exploited. To further reduce the power dissipation, a low-power ADC, which is based on a Successive Approximation Register(SAR) architecture with an on/off-time controlled comparator and passive sample and hold, is also presented. Our algorithmic and architectural level approaches are implemented and fabricated in standard $0.35{\mu}m$ CMOS technology. The testchip shows a good detection accuracy of 99.32% and very low-power consumption of $19.02{\mu}W$ with 3-V supply voltage.

• Archives of Plastic Surgery
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• v.44 no.1
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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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• v.51 no.5
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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.