Why don't you pull your head out of your arse and read the update on pacemakers in the July issue of Anesthesiology, along with the ACC/AHA guidelines, along with perhaps the best paper about PM in the '99 annals of surgery..look up authors Madigan and Mehmet Oz. This paper will tell you exactly how the interference can and does interfere with various PM.
Pacemekers DO pick up electrical interfenence. Just look at your EKG leads when some one is using the monopolar. The pacemaker sees the same thing. It is programmed to try to block out interference, however if it can not then it will see this interference as noise and can revert to an asynchronous mode at a rate determined by the manufacturer. Talk to your EP guys. I have gone over this with them and they do see this.
Below are some other ways in which EMI can interfer with PM. Remember, there are two tyopes of EMI..conducted(bovie) radiated(MRI).
1.)Signal may be interpreted as cardiac in origin, and temporarily inhibit or trigger output.
2.)The signal may be interpreted as noise, and temporarily cause reversion to an asynchronous mode at a rate set by the manufacturer.-very common,
3.The signal may be interpreted as a programming signal, leading to inappropriate reprogramming.
4.Long bursts of electrocautery can result in a train of electrical impulses conducted down the lead causing atrial or ventricular fibrillation.
5.)High levels of electrocautery can pass down the leads and cause thermal burns in the endocardium, causing an inability of the pacer to capture and pace.
6.High levels of current can pass from the leads to the pulse generator and cause irreversible loss of battery output.
Also, the fourth symbol determines a rate variable capability....can be set to vibration, RR, CO, pH and allows for the pacer to vary according to metabolic demand. The impedence sensors(RR), commonly cause problems in the OR when using HP monitors.
In addition, and this statement really shows your ignorance..50 pacemakers can not be reprogrammed at the same time...While all of the carious manufacturers have agreed to the nomenclature for PM, each manufacturer uses a different wand for reprogramming. These wands are NOT compatible with eachother.
The purpose of this statement was to see if anyone's hospital has a policy. When Iwas a resident pts would often show up with a PM, have no idea why it was placed and almost never had their PM ID card. With such strong statements from the ASA and AHA regarding the pre andpost evaluation of PM this has become an issue not only for pt care, but for legal issues as well. Also, both guidant and medtronics recalled a ****load of PM this year for problems with battery function.....
