The current design of an innovative left ventricular assist device (LVAD) makes use
of magnetic levitation technology, which enables the rotors of the device to be completely
suspended by magnetic force, reducing friction and blood or plasma damage. However,
this electromagnetic field can result in electromagnetic interference (EMI), which
can interfere with proper functioning of another cardiac implantable electronic device
(CIED) in its direct proximity. Approximately 80% of patients with an LVAD have a
CIED, most frequently an implantable cardioverter-defibrillator (ICD). Several device–device
interactions have been reported, including EMI-induced inappropriate shocks, inability
to establish telemetry connection, EMI-induced premature battery depletion, undersensing
by the device, and other CIED malfunctions. Unfortunately, additional procedures,
including generator exchange, lead adjustment, and system extraction, are frequently
required because of these interactions. In some circumstances, the additional procedure
might be preventable or avoidable with appropriate solutions. In this article, we
describe how EMI from the LVAD impacts the functionality of the CIED and provide possible
management options, including manufacturer-specific information, for the current CIEDs
(eg, transvenous and leadless pacemakers, transvenous and subcutaneous ICDs, and transvenous
cardiac resynchronization therapy pacemakers and ICDs).
Keywords
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Article info
Publication history
Published online: February 27, 2023
Publication stage
In Press Journal Pre-ProofFootnotes
Funding Sources: The authors have no funding sources to disclose.
Disclosures: Dr Miller has received fellowship salary support and lecture honoraria from Abbott Electrophysiology, Biotronik, Inc., Boston Scientific Corp., and Medtronic, Inc. All other authors have no conflicts of interest to disclose.
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