迷走神经电刺激
植入式心律转复除颤器
医学
心肌梗塞
癫痫
重症监护医学
迷走神经
医疗急救
刺激
心脏病学
内科学
精神科
作者
Chokanan Thaitirarot,Shirley Sze,Timothy Hodson,R Pathmanathan,Harshil Dhutia
标识
DOI:10.1093/ehjcr/ytae214
摘要
Abstract Background Vagus nerve stimulation (VNS) is an established therapy for drug-resistant epilepsy and depression. While VNS coexistence with cardiac pacemakers is considered safe, its interaction with implantable cardioverter defibrillators (ICDs) remains poorly understood. The concern revolves around the potential for VNS stimulation to interfere with ICD function, potentially resulting in inappropriate therapy or changes in cardiac pacing. Case Summary We present the case of a 50-year-old woman with drug-resistant epilepsy who underwent VNS device implantation and subsequent transvenous ICD placement for primary prevention post-myocardial infarction. These devices were thoughtfully situated contralaterally, with a minimum 10 cm separation. Comprehensive testing and follow-up demonstrated no interactions during device programming or serial assessments. Simultaneous interrogation of both devices with their respective telemetry wands caused chaotic artifacts in all channels on the ICD, likely due to electromagnetic interference. Importantly, this interference did not affect ICD sensing. Discussion The coexistence of VNS and ICD in a patient is an emerging scenario with limited previous reports, yet our findings align with prior cases involving VNS and pacemakers. Emphasizing the need for optimal device separation and meticulous evaluation, particularly at maximum VNS output and ICD sensitivity settings, ensures their safe and feasible coexistence. Conclusion As the use of VNS alongside cardiac implantable electronic devices (CIEDs) becomes more common, a diligent evaluation for potential interactions is imperative. Our case highlights the successful coexistence of VNS and ICD, underscoring the importance of careful monitoring and evaluation to guarantee the safe utilization of these two devices.
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