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Implanted Devices and Perioperative Magnet Application

ICDs and Magnets: Magnet application for ICDs disables tachyarrhythmia detection and therefore does not allow shocks for VT or VF. Only apply a magnet to an ICD for surgical procedures. Be aware the magnet will not cause asynchronous pacing as it would in a pacemaker. Continuous cardiac monitoring by an external monitor is always necessary when a magnet is placed on any device. If, during surgery, the ICD has been programmed off, an external defibrillator must be attached and used, if necessary, to shock the patient back into sinus rhythm. If using a magnet, just remove it if defibrillation is needed.

The following are brands will deactivate ICD function if a magnet is placed: Medtronic (1800 - MEDTRONIC) St. Jude (1800 - 722-3774) Biotronic (1800 - 5470394)

BEWARE OF ANY GUIDANT DEVICE!! Guidant devices do not always shut off ICD function when magnet is placed!! Very rarely some of them may be damaged by the magnet!! If there is no info from previous records, call Guidant to determine magnet response. If the kind device is unknown (i.e. no card), get CXR before calling Guidant. Guidant/Boston Scientific 1800 - CARDIAC Note, if it doesn't turn off with a magnet, an EP specialist will need to program it off. Pacemaker and Magnets: All brands EXCEPT MEDTRONIC AT500 will automatically go to asynchronous mode with magnet placed (You should be able to see this on the ECG tracing). If the patient has a MEDTRONIC AT500, check records to see if EP comments whether patient is pacemaker dependent. If not pacemaker dependent, no worries. If pacemaker dependent, EP specialist may need to program to asynchronous mode prior to cautery depending on the proximity of site and that of the procedure

Information on all brands of devices is available at http://www.sjm.com/devices/devicereferenceguide.aspx

When magnet is removed from pacemakers and ICDs, most will automatically go back to original programmed parameters. See note above about Guidant ICDs.

Andrea Styron MD, Kathleen Brink RN EP clinician, Ron Olson MD

May 2008

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Microsoft Word - Syllabus09.doc