Basic ResearchInterference of Electronic Apex Locators with Implantable Cardioverter Defibrillators
Section snippets
Material and Methods
Four different EALs (Table 1), the Root ZX Mini (Morita Corp, Irvine, CA), Apit 11 (Osada Electric Co, Ltd, Tokyo, Japan), Root ZX II (Morita Corp), and VDW Gold (VDW, Munich, Germany), were tested for their ability to interfere with the correct function of 3 commonly used ICDs. The ICDs selected (Fig. 1) for testing were the Biotronik Lumax 540 VR-T (Biotronik SE & Co KG, Berlin, Germany), Boston Scientific Cognis 100-D (Boston Scientific Co, Natick, MA), and Medtronic Protecta XT CRT-D
Results
All 4 different types of EALs and the negative control failed to produce EMI in each of the ICDs tested (Fig. 2A) and in all repetitive tests (Table 3). These results were categorized as EMI-0. This is in contrast to the results with the electrosurgical unit that served as a positive control. During the operation of the surgical unit, each ICD detected interference in all repeated tests that were misdiagnosed as episodes of ventricular tachycardia and resulted in the delivery of shocks in all
Discussion
Pacemakers and ICDs are an effective treatment for life-threatening arrhythmias, and ICDs reduce mortality caused by sudden cardiac death in high-risk patients (19). In the United States, 2.9 million patients received a permanent pacemaker between 1993 and 2009, and the number of pacemakers implanted per year is still increasing (20). More than 66.000 ICDs are implanted annually in the United States (21). In Europe, the number of new implants of pacemakers ranged from 121–1,134 per million and
Acknowledgments
The authors thank Noortje Bijvoet and Mariska de Blaauw for their technical assistance with this experiment and to Arjen van Wijk for his valuable advice.
The authors deny any conflicts of interest related to this study.
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