Interference in implanted cardiac devices, part II.

Patients with implanted cardiac devices (generally of advanced age and with severe cardiovascular disease) often require diagnostic and therapeutic procedures that involve strong sources of EMI. It should be emphasized that with appropriate planning most of these procedures can be performed safely. Consultation regarding exposure to EMI in the medical environment constitutes a frequent clinical practice issue for physicians and nurses caring for patients with pacemakers and implantable cardioverter defibrillators (ICDs). The routine use of prepocedural checklists to identify patients with implanted cardiac devices in advance is strongly recommended.1 Likewise, all institutions (especially those with dedicated staff and clinics) should have written policies regarding evaluation and management of patients before, during, and after procedures involving sources of EMI. Continuous education of patients and colleagues in other specialties and avoidance of improvisation will go a long way in preventing bad outcomes and reducing legal liability.