Elektromagnetische Interferenz von aktiven Herzrhythmusimplantaten im Alltag und im beruflichen Umfeld

Influence of Carbon-Based Fillers on the Electromagnetic Shielding Properties of a Silicone-Potting Compound

The effect of carbon-based additives on adhesives and potting compounds with regard to electrical conductivity and electromagnetic interference (EMI) shielding properties is of great interest. The increasing power of wireless systems and the ever-higher frequency bands place new demands on shielding technology. This publication gives an overview of the effect of carbon-based fillers on electrical conductivity, electromagnetic shielding properties, and the influence of different fillers and filler amounts on rheological behavior. This work focuses on carbon black (CB), recycled carbon fibers (rCF), carbon nanotubes (CNTs), and complex nanomaterials. Therefore, silicon samples with different fillers and filler amounts were prepared using a dual asymmetric centrifuge and a three-roll mill. It has been found that even with small filler amounts, the electromagnetic shielding properties were drastically raised. The filler content as well as the dispersion technique have a significant influence on most of the fillers. It has also been found that the complex viscosity is strongly influenced by the dispersion technique as well as by the choice and amount of filler. In the experiments carried out, shielding values of over 20 dB were achieved with several fillers, whereby even 43 dB were reached with complex, pre-crosslinked fillers. This signal reduction of up to 99.99% enables almost complete shielding of the related frequency.

[Electromagnetic interference : Pacemakers, cardiac resynchronization therapy devices, implantable cardioverter-defibrillator]

Patients with cardiac pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy devices (CRT) are exposed to different types of electromagnetic interference (EMI) at home and at work. Due to the constantly increasing role of electrically active appliances in daily use and the introduction of new therapy concepts such as the leadless cardiac pacemaker and the subcutaneous defibrillator, this topic is of great relevance. The further development of the implanted devices and the almost complete use of bipolar leads has reduced the overall risk of EMI. This review article provides information about the current status of possible interference in the private environment and how to avoid it. In addition, information is provided on how to deal with occupational sources of interference.

Safety of bioelectrical impedance analysis in advanced heart failure patients

BACKGROUND

Cardiac cachexia and frailty are major complications of advanced heart failure (AHF). Bioelectrical impedance analysis (BIA) may provide valuable information regarding fluid balance, muscle mass and prognosis. The main concerns regarding the use of BIA in AHF patients remain arrhythmias and electromagnetic interferences with cardiac implantable electronic devices (CIEDs). Reliable data regarding patients on continuous-flow ventricular assist device (cf-VAD) remain scarce. The aim of this study is to evaluate the safety of BIA in AHF patients on pro-arrhythmogenic therapy with an implanted CIED and/or with a cf-VAD.

METHODS

We prospectively performed 217 BIA measurements in 143 AHF patients at risk of severe arrhythmias due to inotropic support/a history of ventricular arrhythmias and/or treated with CIED, including 104 patients with an ICD, CRT or pacemaker and 95 patients with a cf-VAD. All patients were under continuous Electrocardiogram (ECG) monitoring and clinical surveillance for 24 hours.

RESULTS

No adverse events were observed during the 217 BIA measurements: No rhythm disturbances were documented in the telemetric monitoring during or within 30 minutes after the measurement. CIEDs showed no malfunction, regardless of the location measured or the device manufacturer. In particular, no inappropriate shocks were observed. No alarms, flow disturbances, or malfunctions of the cf-VAD occurred during or after the measurements.

CONCLUSION

We consider BIA a safe measurement with major clinical relevance in our cohort of AHF patients, despite an increased arrhythmic potential on inotropic support or the presence of implanted electronic devices (ICD, CRT, pacemaker and cf-VAD).