Predicting and Suppressing Oversensing of a Pacemaker in Plain X-Ray Photography

Norihiko Akiba, Masashi Takeda, Giichiro Nakaya, Osamu Nakamura, Joel Matsumoto, Kyoichi Ito, Morio Shimada, Kohki Yoshikawa

Department of Clinical Engineering, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Department of Radiological Technology, Nihon Institute of Medical Science, Moroyama, Japan.
Department of Radiology, Japanese Red Cross Medical Center, Tokyo, Japan.
Department of Radiology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Graduate Division of Medical Health Sciences in Graduate School of Komazawa University, Tokyo, Japan.

DOI: 10.4236/ojrad.2012.24024                

Abstract

We conducted experiments of oversensing generation of pacemaker (PM) and X-irradiation direction dependency of PM, and examined the oversensing suppression method, using 8 different types of PMs. It was found out from this experiment that oversensing would occur when some conditions (X-irradiation direction, X-irradiation intensity) are met. Oversensing occurred with the most low irradiation conditions (kV × mA) when PM was irradiated at 90° (vertically to C-MOS; Complementary Metal Oxide Semiconductor). The acuter the angle of irradiation is (α > 90° < α), the higher the irradiation conditions (kV × mA) at which oversensing start to occur. In plain X-ray photography, oversensing was confirmed under the irradiation conditions of (cervical spine, thoracic spine, lateral thoracic spine, rib, shoulder joint, collarbone, humerus, and chest).Once the irradiation angle and irradiation conditions (kV × mA) are available, oversensing is predictable to some extent. Our findings will help to predict oversensing generation of plain X-ray photography and suppress oversensing. Oversensing can be suppressed in most of the radiography by lowering tube current to 100 mA, but a 1.0 mm High-Density Tungsten Sheet must be put on PM in high tube voltage radiography.

Keywords

Oversensing; Pacemaker; C-MOS; General X-Ray Equipment for Diagnosis

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	C. H. McCollough, J. Zhang, A. N. Primak, W. J. Clement and J. R. Buysman, “Effects of CT Irradiation on Implantable Cardiac Rhythm Management Devices,” Radiology, Vol. 243, No. 3, 2007, pp. 766-774. doi:10.1148/radiol.2433060993
[2]	O. Nakamura, G. Nakaya, S. Ogashiwa, A. Hashimoto and M. Kondou, “Experimental Study of the Influence on Pacemakers of X-Rays from Angiocardiography Equipment,” Japanese Journal of Radiological Technology, Vol. 64, No. 3, 2008, pp.335-341. doi:10.6009/jjrt.64.335
[3]	N. Umezawa, M. Hirose and T. Shinbo, “Verification of Irradiation Conditions of X-Rays That Influence Implantable Cardiac Pacemakers,” Japanese Journal of Radiological Technology, Vol. 64, No. 7, 2008, pp. 795-804. doi:10.6009/jjrt.64.795
[4]	N. Oda, H. Nakajima, H. Abe, S. Koyama and S. Kakeda, “Effect of Diagnostic X-Rays of Implantable Cardiac Pacemakers and Implantable Cardioverter Defibrillators, and It’S Management,” Japanese Journal of Radiological Technology, Vol. 64, No. 7, 2005, pp. 805-813. doi:10.6009/jjrt.64.805
[5]	S. Yamaji, S. Imai and F. Saito, “Does High-Power Computed Tomography Scanning Equipment Affect the Operation of Pacemakers?” Circulation Journal, Vol. 70, No. 2, 2006, pp. 190-197. doi:10.1253/circj.70.190
[6]	T. Ushijima, Y. Yamao, N. Nagasawa, M. Matsuzuki and T. Sasou, “Partial Electrical Reset of CT Irradiation on Implantable Cardiac Devices: Relationship between Reset and Tube Voltage, Tube Current, and Rotation Time,” Japanese Journal of Radiological Technology, Vol. 67, No. 6, 2011, pp. 648-653. doi:10.6009/jjrt.67.648
[7]	N. G. Blamires and J. Myatt, “X-Ray Effects on Pacemaker Type Circuits,” Pacing and Clinical Electrophysiology, Vol. 5, No. 2, 1982, pp. 151-155. doi:10.1111/j.1540-8159.1982.tb02206.x
[8]	M. Niehaus and J. Tebbenjohanns, “Electromagnetic Interference in Patients with Implanted Pacemakers or Cardioverter-Defibrillators,” Heart, Vol. 86, No. 3, 2001, pp. 246-248.
[9]	Pharmaceuticals and Medical Devices Safety Information, No. 213, 2005, pp. 3-4.
[10]	Pharmaceuticals and Medical Devices Safety Information, No. 221, 2006, pp. 12-15.
[11]	Pharmaceuticals and Medical Devices Safety Information, No. 263, 2009, pp. 34-36.
[12]	D. L. Hayes, P. J. Wang, D. W. Reynolds, M. Estes 3rd, J. L. Griffith, et al., “Interference with Cardiac Pacemakers by Cellular Telephones,” The New England Journal of Medicine, Vol. 336, 1997, pp. 1473-1479. doi:10.1056/NEJM199705223362101