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Use of a Transurethral Microwave Thermotherapeutic Device With Permanent Pacemakers and Implantable Defibrillators

  • Author Footnotes
    1 Ms Rasmussen is now with Guidant Corporation, St Paul, Minn.
    Mary Jane Rasmussen
    Footnotes
    1 Ms Rasmussen is now with Guidant Corporation, St Paul, Minn.
    Affiliations
    Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn
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  • Robert F. Rea
    Affiliations
    Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn
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  • Jeffrey L. Tri
    Affiliations
    Telecommunications and Mobile Services, Mayo Clinic, Rochester, Minn
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  • Thayne R. Larson
    Affiliations
    Department of Urology, Mayo Clinic, Scottsdale, Ariz
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  • Author Footnotes
    2 Dr Hayes has received speaking honoraria from Medtronic, Guidant, St Jude, and ELA; serves on the advisory boards of Medtronic, Guidant, and ELA; and has stock holdings in Medtronic, Guidant, and St Jude.
    David L. Hayes
    Correspondence
    Address reprint requests and correspondence to David L. Hayes, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905
    Footnotes
    2 Dr Hayes has received speaking honoraria from Medtronic, Guidant, St Jude, and ELA; serves on the advisory boards of Medtronic, Guidant, and ELA; and has stock holdings in Medtronic, Guidant, and St Jude.
    Affiliations
    Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn
    Search for articles by this author
  • Author Footnotes
    1 Ms Rasmussen is now with Guidant Corporation, St Paul, Minn.
    2 Dr Hayes has received speaking honoraria from Medtronic, Guidant, St Jude, and ELA; serves on the advisory boards of Medtronic, Guidant, and ELA; and has stock holdings in Medtronic, Guidant, and St Jude.

      Objective

      To determine whether a device (Urologix Targis system) used for transurethral microwave treatment interferes with sensing, pacing, and arrhythmia detection by permanent pacemakers and implantable cardioverter-defibrillators (ICDs).

      Methods

      We tested 13 pacemakers in both bipolar and unipolar sensing configurations and 8 ICDs in vitro. Pacemakers and ICDs were programmed to their most sensitive settings. Energy outputs of the microwave device were typical of those used clinically. The probe of the microwave device was anchored 1.2 cm from the pacemaker or ICD being tested.

      Results

      No sensing, pacing, or arrhythmic interactions were noted with any ICD or any pacemaker programmed to the bipolar configuration. One pacemaker (Guidant Vigor 1230) showed intermittent tracking when programmed to the unipolar configuration.

      Conclusions

      Most patients with permanent pacemakers or ICDs can safely undergo transurethral microwave therapy using the device tested. Pacemakers and ICDs should be programmed to the bipolar configuration (if available) during therapy. The pacemaker or ICD should be interrogated before and after therapy to determine whether programming changes occurred as a result of treatment. However, our findings suggest that this is unlikely.
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      REFERENCES

        • Hayes DL
        Electromagnetic interference and implantable devices.
        in: Hayes DL Lloyd MA Friedman PA Cardiac Pacing and Defibrillation: A Clinical Approach. Futura Publishing Co, Armonk, NY2000: 519-539
        • Larson TR
        • Blute ML
        • Tri JL
        • Whitlock SV
        Contrasting heating patterns and efficiency of the Prostatron and Targis microwave antennae for thermal treatment of benign prostatic hyperplasia.
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