LETTER
More on Patients with Implantable Cardioverter-Defibrillators
John M. Embil, MD, FRCPC, and
John S. Geddes, BSc, MD, FRCP
1 December 1995 | Volume 123 Issue 11 | Pages 892-893
TO THE EDITOR:
Pinski and Trohman [1] address key issues of concern to both the electrophysiologist and nonelectrophysiologist regarding implantable cardioverter-defibrillators. An additional aspect is that of patients returning to work after the implantation of a cardioverter-defibrillator.
We have reported [2] the case of a male are welder with ventricular tachycardia that was refractory to medication. He initially refused implantation of such a device because his safety at work after implantation could not be guaranteed, and he was anxious about not being able to return to his place of employment. Because of ongoing ventricular tachycardia, the patient consented to having the device implanted but insisted on returning to his potentially unsafe job. On discharge from the hospital, he was fully evaluated at his work place for the potential effects of electrical interference; none was experienced initially or over the next 4 years. Fetter and colleagues [3] recently reported similar results.
Should patients wish to return to potentially unsafe work environments, appropriate electromagnetic testing must be done to ensure that their implantable cardioverter-defibrillator is safe under such conditions.
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Author and Article Information
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University of Manitoba Health Sciences Centre; Winnepeg, Manitoba R3E 073; Canada
1. Pinski SL, Trohman RG. Implantable cardioverter-defibrillators: implications for the nonelectrophysiologist. Ann Intern Med. 1995; 122:770-7.
2. Embil JM, Geddes JS, Foster D, Sandeman D. Return to arc welding following defibrillator implantation. Pace Pacing Clin Electrophysiol. 1993; 16:2313-8.
3. Fetter J, Benditt DG, Stauton MS. EMI effects from welding and motors on ICDS as tested in the hostile worksite [Abstract]. Circulation. 1994; 90:I498.
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