SCS and pacemaker / AICD

[likeaboss]

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Is the interaction between pacemakers and SCS theoretical or real? I always have a pacemaker / AICD rep present when activating my SCS during a trial. I was recently told by a SCS rep that this is theoretical and has never resulted in a complication.

Is this just a myth?


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[painfree23]

Done SCS trials on PPM patients before without any problem.ms. Never called the rep, but made sure the cardiologist was OK with it

 

[likeaboss]

Done SCS trials on PPM patients before without any problem.ms. Never called the rep, but made sure the cardiologist was OK with it

Ahh yes I have done SCS trials and implants on patients with pacemakers without an issue, and I had the rep present. But my question is more what is the right move?

I don't want my 50th SCS / pacemaker patient to have a lethal arrhythmia...


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[emd123]

I always clear it with the cardiologist to do it with a magnet taped with foam tape over the pacer or defibrillator. They almost always say yes. Maybe one in 10 times they’ll want their rep there, which I do when recommenced. I’ve never had an interaction.

I think the concern for stimulation being interpreted by an AICD as a reason to shock, is more of a real concern that a fatal (or any) arrhythmia caused by a stimulator. Either way, I’ve never had either happen.

And remember, the magnet doesn’t turn off either device, it just turns off sensing (AICD) so the device doesn’t shock after sensing your Stim current, and/or put it in a default pacing rate (usually 60) for a pacer.

My guess is it’s more theoretical than real, but I’m not about to abandon my CYA measures until it’s standard of care.