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Will shockwave lithotripsy (for the treatment of kidney stones) impact my pacemakerís function?

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Shock wave lithotripsy uses a spark gap or electromagnetic transducer to produce a shock wave for patients with renal calculi (kidney stones).

The pacemaker may sense the electrical signal from a lithotripter as intrinsic heart activity and cause a single beat inhibition of the ventricular output pulse. Single beat inhibition wonít be noticed by the patient.

For Physicians & Health Care Professionals
To minimize potential inhibition, time shock wave delivery synchronously with the patientís R-wave. Extracorporeal Shock Wave Lithotripsy (ESWL) should be performed in the R-wave triggered mode. ESWL can trigger the atrial output pulse and the subsequent inhibition of the following ventricular pulse. Program dual pacemakers to the VVI or VOO mode prior to ESWL to prevent this occurrence.

ESWL can permanently damage the piezoelectric crystal in an activity sensor based pacemaker if the ESWL focal point is directed towards the pacemaker. Focus the beam at least six inches away from the implanted pacemaker. Program activity sensor based pacemakers to a non-rate responsive pacing mode prior to ESWL therapy.

Perform a thorough assessment of the pulse generator immediately prior to and after exposure to ESWL. This will rule out any device damage. For activity sensor based pacemakers, make sure to assess sensor function after an ESWL procedure. We recommend including a copy of the programmer printouts in the patientís records.


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