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Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants
Journal article   Open access   Peer reviewed

Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants

Tuppence Richman, Tony Stanton, Michael Fryer, Naresh Dayananda and Matthew Tung
Pacing and Clinical Electrophysiology, Vol.46(2), pp.93-99
2023
DOI: https://doi.org/10.1111/pace.14609
PMID: 36269082
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Evaluating the magnet response in deep subcutaneous implanted cardioverter defibrillator implants1.84 MBDownloadView
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https://doi.org/10.1111/pace.14609View
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Abstract

implantable cardiac devices magnet response subcutaneous implantable cardioverter defibrillators
Introduction: The manufacturer of subcutaneous implantable cardioverter defibrillators (SICDs) acknowledges that 'deep implants' may fail to elicit a magnet response, however, do not define 'deep implant' or recommend a maximum implant depth. This study aims to systematically evaluate the effect of subcutaneous tissue depth and magnet types on evoked magnet response. Methods: Sunshine Coast University Hospital's SICD cohort underwent magnet response evaluation; where bar and donut magnets were compared and the evoked magnet response was recorded in three separate zones, guided by a template. Ordinal regression (OR) models assessed the relationship between the evoked magnet response and tissue depth (TD), measured via post implant XRay. The patient's ability to hear the magnet response audible tone was recorded. Results: Patients (n = 39) with measurable TD (n = 30) were analyzed. The bar magnet evoked a magnet response in all zones in 53% of patients, compared with 73% of patients with the donut magnet (p = 0.18). The relationship between bar magnet response and TD showed the odds of an evoked magnet response decreased by 11% every 1 mm increase in TD (OR of 0.89, p < 0.01), whereas the donut magnet decreased by 16% per 1 mm (OR of 0.84, p < 0.01). Directly over the SICD was the most effective in evoking magnet response with the bar (85% of patients), and off centre was most effective for the donut magnet (100%). BMI and Praetorian score were not significantly associated with magnet response. We found 23% of patients were unable to detect the audible tone. Conclusion: We observed a statistically significant association between TD and ability to evoke magnet response. The bar magnet was less reliable than the donut magnet for therapy inhibition in deep implants.

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Cardiac & Cardiovascular Systems
Engineering, Biomedical

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