Deep Brain Stimulation in Patients With Concomitant Cardiac Pacemakers: A Case Series

Oper Neurosurg (Hagerstown). 2019 Dec 1;17(6):549-553. doi: 10.1093/ons/opz018.

Abstract

Background: Deep brain stimulation (DBS) is a treatment modality increasingly utilized in the management of neurological and psychiatric conditions. Neurosurgical technical considerations and contraindications have yet to be thoroughly characterized in the literature. The patient population for DBS includes many elderly patients with multiple comorbidities who require treatments and investigations that expose them to electromagnetic fields of varying strengths and durations, including other implanted electromodulatory devices.

Objective: To determine if clinically significant interference arises between DBS and cardiac pacemaker systems.

Methods: Here we audited 8 patients, mean age 72, with cardiac pacemakers and DBS implanted from 2007 to 2015. We investigated details of their neurological and electrocardiological treatment and progress and sought evidence for interference between the two systems.

Results: We found no evidence of DBS dysfunction, and only one case of abnormal pacemaker interrogation 2 yr post-DBS implantation was found, which was thought to be secondary to a medication issue rather than neuromodulation interference.

Conclusion: Our research reassures the clinician that pacemakers and DBS systems do not appear to affect one another and provides guidance on minimizing possibility of this.

Keywords: Cardiac pacemakers; Deep brain stimulation; Electronic interference; Surgical implantation; Surgical safety.

MeSH terms

  • Aged
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / therapy
  • Cardiac Pacing, Artificial*
  • Cardiac Resynchronization Therapy
  • Cardiac Resynchronization Therapy Devices
  • Deep Brain Stimulation*
  • Dystonia / complications
  • Dystonia / therapy
  • Female
  • Heart Block / complications
  • Heart Block / therapy*
  • Humans
  • Implantable Neurostimulators*
  • Male
  • Middle Aged
  • Pacemaker, Artificial*
  • Parkinson Disease / complications
  • Parkinson Disease / therapy*