interogation after surgery

we have an ongoing discussion about the need to interogate a pacemaker after having been stopped with a magnet during a surgical procedure. our anesthesiologist demand it even though the pacer reps say it is not nessesary. unable to find any supportive literature. thanks for any feedback.

2 Comments

Interrogation After Surgery

by SMITTY - 2013-02-19 08:02:18

In some of the literature I have read on PMs I have seen where anytime a PM is stopped by a magnet it should be rechecked as it is possible for the programing of the PM to be disturbed .

I have been getting my PM (I'm on my second one now) checked every three months for 13 years at the Scott & White Device Clinic in Temple, TX. Every time the magnet is removed the nurse/technician always rechecks the PM to be sure it is working as it should. I was not aware they did this until one day at a checkup when they removed the magnet I unconsciously started getting up to leave and was told keep my seat until my PM could be checked and the electrodes were removed. This brought forth a short conversation between the two of us and I learned S&W people always do this final check as they also say the magnet could interfere with the basic programing of the PM.

True or not, I don't know.

Smitty

Interesting

by ElectricFrank - 2013-02-21 02:02:43

My first thought is that I would go with the reps information. They have direct contact with the engineering dept at the manufacturer and should have the latest and best information.

The use of the "magnet" for programming is a different situation than using it for surgery. Actually, my original Medtronics KDR 701 and my new Adapta don't actually use a true magnet for programming. The puck sends a radio frequency signal to the pacer and it responds. Where I first got on to this is that my Carelink monitor doesn't have the required symbol for being magnetic on it. The final check is the one that produces the Final Report showing the complete setting profile.

The magnet for surgery is an actual permanent magnet that operates an internal reed switch in the pacer. All pacers are required to have this feature. Activation of the magnet puts the pacer in a safe mode with fixed rate pacing to make it less vulnerable to external interference. While activation and deactivation of this mode won't affect the settings, there is always the chance that during the surgery some device will have had a strong enough signal to affect the pacer. That's where the warning to check programming after a magnet event originated.

Like everything in the medical field once a procedure gets started it is hard to make it go away. For instance the small waveforms on an ECG chart are not optimum for understanding the operation of the heart. The format originated many decades ago and even though modern technology can produce a much better graph, cardiologists still insist on grandpa's chart.

frank

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Member Quotes

A properly implanted and adjusted pacemaker will not even be noticeable after you get over the surgery.