An in vitro evaluation of electromagnetic interference between implantable cardiac devices and ophthalmic laser systems

Aims: Ophthalmic laser treatments are discouraged in patients with implantable pulse generators (IPGs, pacemakers) and implantable cardioverter defibrillators (ICD) due to potential effects of the electromagnetic interference (EMI) emitted by ophthalmic laser systems. We assessed the effects of EMI generated by ophthalmic laser systems and laser discharge on IPG and ICD function. Methods and results: Two implantable devices, one Victory dual-chamber IPG (St Jude Medical, Minneapolis, MN, USA) and one Atlas II + dual-chamber ICD (St Jude Medical), were consecutively placed in a simulated thoracic chamber and exposed to three ophthalmic laser systems: the VISX Star S4 Excimer Laser, Lumenis Selecta II 532 neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, and Ellex Ultra Q 1064 nm Nd:YAG laser. For each laser system, the apparatus was placed in the relative position of a patient while common laser procedures were delivered to a plastic object. Device pacing parameters were programmed to the highest possible sensitivity settings. The pacing and defibrillation function of the implantable devices, including electrograms, were continuously monitored. The EMI emitted from ophthalmic lasers did not lead to oversensing, inappropriate therapy, or change in the programming of the implantable cardiac devices. Manufacturing electrical tests performed on both devices showed that the cardiac devices continued to meet all the specifications for proper device function. Conclusion: The St Jude Medical Victory IPG and Atlas II + ICD were not affected by the EMI emitted by the ophthalmic laser systems. Published on behalf of the European Society of Cardiology. All rights reserved.