Using a Cast Iron Skillet to Resolve Percutaneous Ventricular Assist Device and Implantable Cardioverter-Defibrillator Electromagnetic Interference

利用铸铁煎锅解决经皮心室辅助装置和植入式心脏复律除颤器电磁干扰问题

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Abstract

BACKGROUND: Percutaneous ventricular assist device (pVAD)-induced electromagnetic interference (EMI) can disrupt implantable cardioverter-defibrillator (ICD) telemetry. We describe a novel mitigation strategy using a cast iron skillet. CASE SUMMARY: An 81-year-old woman with an ICD underwent pVAD-assisted percutaneous coronary intervention for cardiogenic shock. Postprocedure interrogation for slow ventricular tachycardia failed due to significant EMI. Because hemodynamic instability precluded reducing pVAD flow to mitigate interference, a cast iron skillet was placed over the heart. This pseudo-Faraday cage successfully restored telemetry. DISCUSSION: Although the "skillet method" aids durable left ventricular assist device interrogation, prior reports suggest inefficacy with pVADs, favoring flow reduction. We report the first successful use of a cast iron skillet to shield Impella EMI, offering a vital strategy for unstable patients unable to tolerate pump weaning. TAKE-HOME MESSAGES: pVAD systems can generate EMI, disrupting ICD telemetry. When hemodynamic instability prevents lowering pVAD flow, a cast iron skillet can assist in shielding EMI and restoring communication.

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