磁悬浮列车对心脏起搏系统的影响

Effect of maglev train on pacemaker

目的观察磁悬浮列车对心脏起搏系统是否存在影响。方法试验分为体外和"体内"两部分。模拟人体起搏系统生理环境的体外测试部分是将脉冲发生器[5家公司的DDDR起搏器及两家公司的双腔埋藏式心脏转复除颤器(ICD)]与双极心房、心室电极导线/及除颤电极导线相联后封闭于含有阻抗约为500Ω的生理盐水塑料袋内,观察磁悬浮列车在不同的三个时间段(驰入车站、安全线外候车时及在行进中的磁悬浮列车车厢内)、不同的脉冲发生器高度(近胸部、站台地面上及行进中的列车地板上)和不同的起搏电极导线极性(单极和双极)下对人机对话过程及起搏参数的影响。"体内"测试部分是在体外试验证实磁悬浮列车对起搏系统无明显影响下才开始实施。选择非起搏依赖的植入心脏起搏器患者及健康对照者安装Holter记录仪后乘坐磁悬浮列车,观察乘坐期间的主诉症状、Holter记录的心电图变化及乘坐磁悬浮列车前后起搏参数的变化。结果①模拟人体起搏系统生理环境的体外测试部分:磁悬浮列车对包括起搏器和ICD在内的多个品牌的脉冲发生器在不同的三个时间段、不同起搏器高度及起搏极性下的人机对话过程和起搏参数无任何影响。②磁悬浮列车对植入心脏起搏器患者未造成不适,全程监护的Holter记录未发现任何干扰现象,也未发现起搏参数设置的任何变化。结论上海磁悬浮列车对心脏起搏系统无干扰作用,植入心脏起搏器患者乘坐上海磁悬浮列车是安全的。

Objective To evaluate the effect of maglev train on pacemaker. Methods In vitro and ＂ in vivo＂ tests were performed in the experiment. In vitro test, the pacemaker （including 5 different company＇s DDDR pacemakers and 2 dual-chamber ICD） connected with the bipolar atrial and ventricular leads was put into the sac infused with physiolgical saline separately, in which the impedance was around 500% to mimic the physiological enviroment in humanbody. The process of the communication between pacemaker and programmer and changes of pacemaker＇s parameters were investigated when maglev train was coming into the platform, waiting outside the secure line when the magelv train on the station and in the moving carriage of maglev train. Besides, different height of pacemaker （ bosom, platform ground and floor of carriage） and pacing polarity （ bipolar and unipo/ar） were also detected to see if any influence in the communication process and parameters. ＂ In vivo＂ test, the patients who was non ventticular pace-dependent and healthy volunteers tided the maglve trian with Holter monitor. However, this part of the test was performed when the result of in vitro showed there was no significant affect of maglev train on pacemaker systems. The symptom, electrocaridiogram changes and pacemaker settings were investigated during this process. Results （1）In vitro experiment, in spite of the different time, different height of pacemaker and different pacing polarity, the maglev trian has no effect on the communication and pacemaker settings. （2）Padents who implanted the pacemaker has no any symptoms during riding the maglev train, while the Holter recording has no signs of interference and no change of pacemaker＇s parameters were detected. Conclusion Maglev train has no effect on the pacemaker system. It is safe for patient who implanted pacemaker to ride Shanghai maglev train.