| Abstract [eng] |
Life-saving treatments, such as pacemakers (PM), implantable cardiac defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices, are used for numerous cardiac conditions. Cardiac rhythm management devices perform different functions, including monitoring for arrhythmias, bradycardia pacing, cardiac resynchronization for heart failure, defibrillation and anti-tachycardia pacing for ventricular tachyarrhythmias. Estimating the exact rate of CIED infections is challenging due to varying definitions, differences in patient populations, and the discrepancies between retrospective and prospective study rates. CIED infections typically occur through two main mechanisms. The most common is contamination of the leads or pulse generator during the initial implantation or later adjustments. Device erosion after these procedures can lead to a pocket infection, which could cause systemic infection. The second mechanism involves infection entering through the bloodstream. Medical devices, such as cardiac implantable electronic devices, have become highly interconnected. This means now CIED’s are more connected and are able to communicate with other devices or networks. This increases the risk of exploitation of cybersecurity vulnerabilities that can affect the device's function. Radiotherapy (RT) is frequently used in cancer treatment and may also be required before or after surgery as an alternative to surgical procedures. There are two types of RT: brachytherapy (internal radiation) and external beam radiation. While radiation can damage surrounding healthy tissue, it can also pose risks to cardiac implantable devices. Although ionizing radiation can harm CIED electronic circuits, and this has raised concerns about potential device malfunctions. Electromagnetic interference (EMI) could radiate from a distance or even be conducted via individuals if they are in contact with the source. Various factors could affect EMI. The programs set on these devices could influence their response to EMI. These programs include sensitivity, polarity, mode, refractory, and blanking periods. If the setting is more sensitive, the device starts to over-sense non-cardiac signals. |
