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Evaluation of the effects of electroporation pulses on implantable cardiac pacemakers

STSM by Tomaž Jarm, Associate Professor

Period of mission: from 03/11/2014 to 31/01/2015

Home institution: University of Ljubljana, Faculty of Electrical Engineering, Ljubljana, Slovenia

Host institution: University of Zagreb, Faculty of Electrical Engineering and Computing, Zagreb, Croatia

Electrochemotherapy of tumors is an effective treatment also for treatment of internal "deep-seated" tumors. Currently it is contraindicated for patients with implanted pacemakers simply as a precaution measure. Whether the high-voltage electric (electroporation) pulses used in electrochemotherapy can interfere with functioning of pacemakers is actually unknown. A series of experiments was performed to assess voltages and currents that could be induced at a pacemaker's sensing/pacing electrodes during application of electroporation pulses. A container filled with physiological saline was used to mimic the physiological conditions when the electrodes are embedded in an internal organ. Both the treatment and the pacemaker electrodes were placed in the container at varying distances. The minimum distance was 1.5 cm to mimic the worst-case situation when the electroporation pulses are delivered at the outer wall of the heart. In addition to the measurements without the pacemaker, the measurements were performed with the pacemaker connected and working in an asynchronous mode. The atrial pacing pulses were used to trigger the delivery of electroporation pulses during the period of ventricular pacing. Thus we were able to monitor the interference of electroporation pulses with a functioning pacemaker during the period when its susceptibility to electrically induced interference is the greatest due to low impedance of its pacing circuitry. We found no evidence of harmful effects that the electroporation pulses might have on functioning of a pacemaker, even though the induced artefacts during the application of pulses can be considerable and can exceed the amplitude of the pacing pulse itself.

Poster presentation(s) originating from this mission

Event 1st World Congress on Electroporation and Pulsed Electric Fields in Biology, Medicine and Food & Environmental Technologies
Location Portorož/Slovenia
Period

06/09 - 10/09/2015

Authors Tomaz Jarm, Branko Milankovic, Damijan Miklavcic, Ratko Magjarevic
Title Preliminary evaluation of exposure of cardiac pacemakers to electroporation pulses

 


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