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ABSTRACT. The number of patients receiving pacemaker implantations has been increasing year in year out, with expanding indications for device therapies with a view to the management of cardiovascular diseases – since the impressive technological developments of this technology starting more than 60 years ago. The sensing of intrinsic cardiac electrical activity is essential for the function of pacemakers and implantable cardioverter-defibrillators (ICDs). The device function may be severely compromised if extraneous, nonphysiologic signals are erroneously identified as cardiac signals, termed oversensing. The nonphysiologic signals usually originate in electromagnetic energy sources and come up as electromagnetic interference (EMI), defined as an electromagnetic phenomenon that degrades the performance or function of a system. Since the inception of cardiac implantable electronic devices (CIEDs), technology has evolved to minimize EMI by using hermetic shielding, improved filtering, and interference rejection circuits. International standards have been developed establishing the upper limit of permissible field intensities, and protocols have been made to test CIEDs against possible interference. Sources of EMI can be classified according to the type and spectral frequency of energy emitted, as well as the environment in which the source is found. We have radiated the EMI that can result from energy emitted for communication purposes or as an unintended effect of other electrical activity, and also conducted EMI like directly conducted galvanic currents that are most often introduced into the body therapeutically, such as by transcutaneous electrical nerve stimulation (TENS), but can also result from physical contact with improperly grounded electrical equipment. The return of the CIED patient to a work environment suspected of high-level EMI may be challenging. There are multiple sources of environmental electromagnetic interference signals in the modern world. It is important to understand a patient’s real problem related to EMI and to take specific measures in order to avoid needless confusion. pp. 93–102

Keywords: pacemaker, pacemaker protocols, electromagnetic interference, environment, life, patient

Cristian Statescu
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Grigore T. Popa University of Medicine, Romania
Catalina Arsenescu Georgescu
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Grigore T. Popa University of Medicine, Romania

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