Literature interpretation of guidelines related to cardiac pacemakers/defibrillators and extracorporeal shock wave lithotripsy

doi:10.3877/cma.j.issn.1674-3253.2024.04.003

Abstract

Abstract:

There is controversy on whether patients with implantable pacemaker (PPM)/cardioverter defibrillator (ICD) can undergo extracorporeal shock wave lithotripsy (ESWL). Previous views have suggested that extracorporeal shock waves may affect the normal function of implanted devices, posing a threat to the patient's life safety. With the development of technology and the continuous updating of device functions, multiple studies have confirmed that patients implanted with PPM/ICD can undergo ESWL under certain measures. This article will provide a detailed description of this.

Key words: Pacemakers, Implantable cardioverter defibrillators (ICD), Extracorporeal shockwave lithotripsy (ESWL)

Xin Li, Xiangkui Deng, Changyong Lin, Yong Guo. Literature interpretation of guidelines related to cardiac pacemakers/defibrillators and extracorporeal shock wave lithotripsy[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 313-317.

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References 36

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制造商	推荐建议
盖腾Guidant	1.应对患者进行持续监测
	2.体外碎石机应该被设为与心电图的R波同步触发，以防止任何由电极放电引起的电磁干扰抑制脉冲发生器的事件
	3.双腔起搏器应设为单腔心室抑制模式，以避免心房起搏脉冲触发碎石机的放电
	4.应在ESWL后检查植入设备
	5.ESWL治疗期间应暂停植入式心脏复律除颤器
美敦力Medtronic	1.植入设备距离靶点>18 cm，仅监测
	2.距离靶点5～18 cm，监测并考虑磁控模式
	3.距离靶点<5 cm，在治疗前后，应对设备进行检测。美敦力（Medtronic）警告称，距离靶点5 cm范围内的设备可能会受到损坏。如果碎石机需要与心电图（ECG）同步，并且能够持续在起搏尖峰后定时关闭，则将设备从双腔起搏模式重新编程至单腔心室抑制模式，有助于避免室性输出的抑制。在进行治疗前后，应考虑采用磁控模式，并对设备进行检测
圣犹达St. Jude	1.起搏器应重新设为单腔心室抑制/单心室输出的模式
	2.碎石机的靶点应距设备至少15 cm
	3.冲击波触发应该与R波同步
	4.应在ESWL后检查植入设备
中国先建	1.要保持碎石机的靶点距离植入设备至少2.5 cm
	2.将磁铁置于设备上方开始磁铁模式（异步起搏）
	3.将起搏器设为异步起搏模式（例如，双腔输出）
	4.碎石术治疗后，取下磁铁或恢复起搏器参数

制造商	推荐建议
盖腾Guidant	1.应对患者进行持续监测
	2.体外碎石机应该被设为与心电图的R波同步触发，以防止任何由电极放电引起的电磁干扰抑制脉冲发生器的事件
	3.双腔起搏器应设为单腔心室抑制模式，以避免心房起搏脉冲触发碎石机的放电
	4.应在ESWL后检查植入设备
	5.ESWL治疗期间应暂停植入式心脏复律除颤器
美敦力Medtronic	1.植入设备距离靶点>18 cm，仅监测
	2.距离靶点5～18 cm，监测并考虑磁控模式
	3.距离靶点<5 cm，在治疗前后，应对设备进行检测。美敦力（Medtronic）警告称，距离靶点5 cm范围内的设备可能会受到损坏。如果碎石机需要与心电图（ECG）同步，并且能够持续在起搏尖峰后定时关闭，则将设备从双腔起搏模式重新编程至单腔心室抑制模式，有助于避免室性输出的抑制。在进行治疗前后，应考虑采用磁控模式，并对设备进行检测
圣犹达St. Jude	1.起搏器应重新设为单腔心室抑制/单心室输出的模式
	2.碎石机的靶点应距设备至少15 cm
	3.冲击波触发应该与R波同步
	4.应在ESWL后检查植入设备
中国先建	1.要保持碎石机的靶点距离植入设备至少2.5 cm
	2.将磁铁置于设备上方开始磁铁模式（异步起搏）
	3.将起搏器设为异步起搏模式（例如，双腔输出）
	4.碎石术治疗后，取下磁铁或恢复起搏器参数

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