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      Influence and safety of electronic apex locators in patients with cardiovascular implantable electronic devices: a systematic review

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          ABSTRACT

          The widespread use of cardiovascular implantable electronic devices has increased concerns regarding using electronic apex locators in patients with these devices. This systematic review investigated the effects and safety of using electronic apex locators in patients with cardiovascular implantable electronic devices.

          Methods: An electronic search in the Cochrane Library, PubMed (MEDLINE), ScienceDirect, and Scientific Electronic Library Online (Scielo) databases for relevant articles published between December 2000 and December 2018 was performed. The search strategy centered on terms related to electronic apex locators use during root canal treatment in patients with cardiovascular implantable electronic devices.

          Results: Seven studies (five in vitro and two in vivo) fulfilled the inclusion criteria for this review. It was found that electronic apex locators can be used safely in patients with cardiovascular implantable electronic devices, when general precautions are followed.

          Conclusions: Although the present review suggests that electronic apex locators can be used safely in patients with implantable cardioverter defibrillators, consultation with patients’ cardiologists remains advisable.

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          Cardiac Device Implantation in the United States from 1997 through 2004: A Population-based Analysis

          Chunliu Zhan, William Baine, Artyom Sedrakyan … (2007)
          OBJECTIVE Use of cardiac devices has been increasing rapidly along with concerns over their safety and effectiveness. This study used hospital administrative data to assess cardiac device implantations in the United States, selected perioperative outcomes, and associated patient and hospital characteristics. METHODS We screened hospital discharge abstracts from the 1997–2004 Healthcare Cost and Utilization Project Nationwide Inpatient Samples. Patients who underwent implantation of pacemaker (PM), automatic cardioverter/defibrillator (AICD), or cardiac resynchronization therapy pacemaker (CRT-P) or defibrillator (CRT-D) were identified using ICD-9-CM procedure codes. Outcomes ascertainable from these data and associated hospital and patient characteristics were analyzed. MEASUREMENTS AND MAIN RESULTS Approximately 67,000 AICDs and 178,000 PMs were implanted in 2004 in the United States, increasing 60% and 19%, respectively, since 1997. After FDA approval in 2001, CRT-D and CRT-P reached 33,000 and 7,000 units per year in the United States in 2004. About 70% of the patients were aged 65 years or older, and more than 75% of the patients had 1 or more comorbid diseases. There were substantial decreases in length of stay, but marked increases in charges, for example, the length of stay of AICD implantations halved (from 9.9 days in 1997 to 5.2 days in 2004), whereas charges nearly doubled (from $66,000 in 1997 to $117,000 in 2004). Rates of in-hospital mortality and complications fluctuated slightly during the period. Overall, adverse outcomes were associated with advanced age, comorbid conditions, and emergency admissions, and there was no consistent volume–outcome relationship across different outcome measures and patient groups. CONCLUSIONS The numbers of cardiac device implantations in the United States steadily increased from 1997 to 2004, with substantial reductions in length of stay and increases in charges. Rates of in-hospital mortality and complications changed slightly over the years and were associated primarily with patient frailty.
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            Cardiac Arrhythmias: Diagnosis, Symptoms, and Treatments.

            Du-Guan Fu (2015)
            The cardiac arrhythmia is characterized by irregular rhythm of heartbeat which could be either too slow ( 100 beats/min) and can happen at any age. The use of pacemaker and defibrillators devices has been suggested for heart arrhythmias patients. The antiarrhythmic medications have been reported for the treatment of cardiac arrhythmias or irregular heartbeats. The diagnosis, symptoms, and treatments of cardiac arrhythmias as well as the radiofrequency ablation, tachycardia, Brugada syndrome, arterial fibrillation, and recent research on the genetics of cardiac arrhythmias have been described here.
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              Effects of external electrical and magnetic fields on pacemakers and defibrillators: from engineering principles to clinical practice.

              Roy Beinart, Saman Nazarian (2013)
              The overall risk of clinically significant adverse events related to EMI in recipients of CIEDs is very low. Therefore, no special precautions are needed when household appliances are used. Environmental and industrial sources of EMI are relatively safe when the exposure time is limited and distance from the CIEDs is maximized. The risk of EMI-induced events is highest within the hospital environment. Physician awareness of the possible interactions and methods to minimize them is warranted.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Libyan J Med
                Journal ID (iso-abbrev): Libyan J Med
                Journal ID (publisher-id): ZLJM
                Journal ID (publisher-id): zljm20
                Title: The Libyan Journal of Medicine
                Publisher: Taylor & Francis
                ISSN (Print): 1993-2820
                ISSN (Electronic): 1819-6357
                Publication date Collection: 2019
                Publication date (Electronic): 21 November 2018
                Volume: 14
                Issue: 1
                Electronic Location Identifier: 1547071
                Affiliations
                College of Dentistry, Taibah University , Madinah Al Munawwarah, Saudi Arabia
                Author notes
                CONTACT Mothanna K. AlRahabi mrahabi@ 123456taibahu.edu.sa College of Dentistry, Taibah University , P O Box 344, Madinah Al Munawwarah, Saudi Arabia
                Author information
                http://orcid.org/0000-0002-3405-9524
                Article
                Publisher ID: 1547071
                DOI: 10.1080/19932820.2018.1547071
                PMC ID: 6249593
                PubMed ID: 30458679
                SO-VID: 86471160-0768-4f39-9f46-25281f339ac4
                Copyright © © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 10 August 2018
                Date accepted : 01 November 2018
                Page count
                Figures: 1, Tables: 1, References: 40, Pages: 8
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Medicine
                Keywords: apex locator,pacemakers,defibrillators,electromagnetic waves,cardiovascular
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: apex locator, pacemakers, defibrillators, electromagnetic waves, cardiovascular

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