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Hughey S, Field R, Campbell D, Cole J, Booth G, Stringer M, Stedjelarsen E. Military concerns for chronic pain stimulator devices. BMJ Mil Health 2023:e002366. [PMID: 37336581 DOI: 10.1136/military-2023-002366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/14/2023] [Indexed: 06/21/2023]
Abstract
Spinal cord stimulators (SCS) and peripheral nerve stimulators (PNS) are increasingly used in the treatment of chronic pain, allowing more patients to resume working and return to activities. Military service members face environmental and occupational hazards that expose them to mechanical and electromagnetic forces, both clinical and industrial, that could potentially alter their function. While there are reports of individual hazards, the risk appears to be nominal based on the large number of devices in use and the limited reported complications with these devices. Since a variety of hazards encountered by military patients have the potential to alter SCS and PNS devices, a brief discussion of each patient's specific exposures and related hazards should occur prior to placement. Overall, these devices have demonstrated safety in hazardous areas and few military patients have contraindications for placement based on these factors alone.
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Affiliation(s)
- Scott Hughey
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Anesthesiology and Pain Medicine, Naval Hospital Okinawa, Okinawa, Japan
| | - R Field
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - D Campbell
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - J Cole
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - G Booth
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - M Stringer
- NASA Langley Research Center, Hampton, Virginia, USA
| | - E Stedjelarsen
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
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Gebhardt U, Irnich W. [Interference with cardiac pacemakers by diathermy tested in various simulation models (author's transl)]. BIOMED ENG-BIOMED TE 1979; 24:10-6. [PMID: 427233 DOI: 10.1515/bmte.1979.24.1-2.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
The inhibited pacemaker (VVI or AAI) has become the most popular in recent years because of its ability to combine a physiological advantage with economical current consumption in cases with spontaneous activity. One of its disadvantages is its sensitivity to external electromagnetic interference. Though today's pacemakers possess effective protection against most interference signals there may be instances in which patients are subjected to uncomfortable or even life-threatening situations. This is the case of "amplitude modulated" or "pulsed" fields with modulation frequencies in the physiological range. Fields of that sort have been found in the vicinity of a welder, an electric steel plant, and in medical practice where therapeutic currents were applied. Even touch-actuated switches may influence a demand pacemaker. However, these situations may be overcome by a device within the pacemaker for simple time analysis which can be carried out with few components. If electromagnetic fields of diathermy equipment are applied, today's pacemakers may react with intolerably high or low rates. They should, therefore, be avoided.
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