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An Unusual Source of Electromagnetic Interference: A Device–Device Interaction
Author(s) -
KOWALSKI MARCIN,
SHEPARD RICHARD K.,
KALAHASTY GAUTHAM,
WOOD MARK A.,
ELLENBOGEN KENNETH A.
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.02757.x
Subject(s) - medicine , electromagnetic interference , troubleshooting , generator (circuit theory) , electrical impedance , electrical engineering , emi , pulse generator , interference (communication) , electrode , voltage , acoustics , computer science , physics , channel (broadcasting) , engineering , power (physics) , quantum mechanics , operating system
Introduction:  Implantable cardioverter‐defibrillators (ICDs) are susceptible to oversensing of extracardiac signals, also known as electromagnetic interference (EMI). We report a case of an unusual source of electrical interference of only the high voltage (HV) impedance measurement in the Teligen™ ICD (Boston Scientific, St. Paul, MN, USA) caused by electrical interference from an electrosurgical generator with an electrocautery patch located in close proximity to the ICD pulse generator.Method and Results:  A patient underwent an uneventful implant of a Boston Scientific Teligen™ 100 ICD. Once the device was inserted in a pocket, interrogation of the device repeatedly demonstrated HV electrode impedance measurements between <20 and 40 Ω and noise only on the HV electrode. A new lead and generator were implanted without a change in the interrogation results. The erroneous measurements of HV impedance were caused by a combination of the close proximity of the electrocautery patch to the ICD generator. The continuous low‐amplitude current emitted by the contact quality monitoring system of the electrosurgical cautery generator interfered with an equally weak current delivered through the lead by the device to measurement HV impedance. The Medtronic Virtuoso™ (Medtronic Inc., Minneapolis, MN, USA) ICD and the St. Jude Medical Current™ DR (St. Jude Medical, St. Paul, MN, USA) ICD were not affected by the patch due to greater magnitude of current delivered by the device to measure HV electrode impedance.Conclusion:  It is important that the operator must be aware of any potential source of EMI, as it may affect the device and require immediate troubleshooting. Failure to recognize this interaction may result in inappropriate and unnecessary pulse generator replacement. (PACE 2010; 994–998)

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