摘要
The prevalence of pacemaker patients among the general population and of conducted energy devices (CED) for law enforcement and self-defence is increasing. Consequently, the question whether cardiac pacemaker (CPM) patients are on particular risk becomes increasingly important. The risk of Taser X26 electric interference with implanted CPM has been investigated by numerical simulation at MRI-based anatomical models of CPM patients with devices implanted at conventional sites (left pectoral, right pectoral and abdominal) and with the monopolar CPM electrode placed at the ventricular apex. In spite of 10fold higher peak voltages the different coupling conditions make Taser-induced CPM interference voltages lower than those caused by external cardiac defibrillators. It is shown that electric interference considerably depends on ECD electrode orientation. The most unfavourable conditions are encountered with ECD electrodes aligned with the line from the CPM electrode tip to CPM can (EPC line). It could be shown that worst case interference voltages of monopolar pacemakers of any kind of implantation remain below the pulse immunity level as defined in safety standards of implantable cardiac pacemakers and of cardioverter defibrillators. However, interference voltages exceed CPM sensing thresholds. Therefore, capturing should be expected at Taser X26 contact mode application at any position at the upper part of the body including the abdomen, both at frontal and dorsal positions.
The prevalence of pacemaker patients among the general population and of conducted energy devices (CED) for law enforcement and self-defence is increasing. Consequently, the question whether cardiac pacemaker (CPM) patients are on particular risk becomes increasingly important. The risk of Taser X26 electric interference with implanted CPM has been investigated by numerical simulation at MRI-based anatomical models of CPM patients with devices implanted at conventional sites (left pectoral, right pectoral and abdominal) and with the monopolar CPM electrode placed at the ventricular apex. In spite of 10fold higher peak voltages the different coupling conditions make Taser-induced CPM interference voltages lower than those caused by external cardiac defibrillators. It is shown that electric interference considerably depends on ECD electrode orientation. The most unfavourable conditions are encountered with ECD electrodes aligned with the line from the CPM electrode tip to CPM can (EPC line). It could be shown that worst case interference voltages of monopolar pacemakers of any kind of implantation remain below the pulse immunity level as defined in safety standards of implantable cardiac pacemakers and of cardioverter defibrillators. However, interference voltages exceed CPM sensing thresholds. Therefore, capturing should be expected at Taser X26 contact mode application at any position at the upper part of the body including the abdomen, both at frontal and dorsal positions.
