Sicherheit der Stromstimulation für implantierte elektrische Stimulatoren

Implantierte elektrische Stimulatoren werden in der Kardiologie als auch in der Neurologie routinemäßig therapeutisch genutzt. Es stellt sich die Frage, ob diese Systeme bei klinischen elektrophysiologisch-diagnostischen Verfahren sicher arbeiten. Anhand einer Metaanalyse entsprechender Studien und einer Recherche in der BfArM-Datenbank wird dargelegt, inwieweit die Stromstimulation ein Risiko für implantierte elektrische Stimulatoren darstellt.

Abstract

Implanted cardiac pacemakers, cardiac defibrillators (ICD) and deep brain stimulators (DBS) are routinely used for cardiac and neurological therapy. Given the sensitive interaction of these devices with the heart or brain physiology, the question arises if concurrently applied electrophysiological examinations exerting electrical stimulations (nerve conduction velocity – NCD), somatosensory-evoked potentials – SEP) could lead to safety problems with these implanted stimulators. Based on a meta-analysis of existing studies, this paper shows that cardiac stimulators are largely robust against such electrophysiological examinations. In contrast, studies are missing that test potential risks with DBS associated with NCD or SEP. However, there are no reports in the BfArM database on adverse effects with DBS during NCD or SEP examinations suggesting that the risk for DBS is quite low.

Schlüsselwörter

Herzschrittmacher - tiefe Hirnstimulation - Sicherheit - Elektrostimulation, - Neurografie

Key words

cardiac pacemaker - deep brain stimulation - safety - electrical stimulation - neurography

• Literatur

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