外源性脉冲电磁场干扰下的心脏起搏器“窗口效应”及防护

“Window Effect” and Protective Measures of Exogenous Pulsed Electromagnetic Field on Implantable Cardiac Pacemaker

现代电网和医疗环境中广泛存在的脉冲电磁场对起搏器佩戴者潜在的电磁干扰不容忽视,但目前缺乏对此类暂态电磁干扰发生机制和防护措施的系统研究.将猪肉组织浸入0.9%氯化钠溶液,构建起搏器术后人体等效离体模型,采用快波前特性电流模拟常见电力设备投切过程和低频脉冲式医疗设备产生的脉冲电磁场对起搏器佩戴者的影响.基于脉冲形成线理论,对脉冲电磁场在胸腔结构中的波型压缩特性进行分析.进一步通过有限元软件建立起搏器与组织结构结合的参数化生物电磁暂态模型.研究结果表明,起搏器在脉冲电磁场中会产生心电图P波尖顶、过感知等故障,通过改变囊袋中导线缠绕方式发现起搏器在电磁干扰环境下,囊袋回路存在“窗口效应”.基于此发现,提出使用复合材料进行“窗口”屏蔽的防护策略,并通过仿真验证该方法可将脉冲电磁场对起搏器的电磁干扰强度有效降低80 dB,初步印证了该防护措施的理论可行性.最后,为电网环境和医疗环境下起搏器佩戴者制定了安全距离.

The electromagnetic interference(EMI) from pulsed electromagnetic field(PEMF) on pacemakers is unignorable in modern power grids and healthcare environments, but there is limited study on the interaction mechanisms and protective measures. In this paper, an in-vitro human chest model for pacemaker implantation is made by using pork tissues immersed in 0.9% sodium chloride solution. The effect of PEMFs generated by the switching actions of common electrical equipment and low-frequency medical equipment on pacemakers is simulated by using fast-front current sources. The pulse forming line theory is employed for analyzing the waveform compression of PEMFs in human thoracic cavity. Further, the parameterized bio-electromagnetic transient model of pacemaker in combination with biological tissues is established in finite element software. The results show that pacemaker malfunctions including pacing inhibition and P pulmonale occur under PEMF. The “Window effect” in subcutaneous pouch under PEMF is found by changing the winding of pacemaker leads in the pouch. Based on the research finding, a protective strategy by using composite materials to shield the window area is proposed. The theoretical feasibility of this protective measure is confirmed by simulation, where the intensity of pacemaker EMI could be reduced by 80 dB when the composite materials shielding is used. Finally, a safe distance is developed for pacemaker wearers in electrical and medical environments.