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Neža Prezelj, Maja Trošt, Dejan Georgiev and Dušan Flisar

D eep brain stimulation (DBS) is increasingly used to treat medically refractory movement disorders including Parkinson’s disease, essential tremor, and dystonia. 5 , 11 , 12 Neurostimulators are implanted for this treatment; however, there are a number of electrical devices in the environment that may affect the function of these devices. The proper functioning of implantable pulse generators (IPGs) can be impaired by electromagnetic interference emanating from electronic devices, electrical machinery, or metal detectors. Strong electromagnetic fields (EMFs

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Joshua M. Rosenow, Howard Tarkin, Elias Zias, Carmine Sorbera and Alon Mogilner

generators. External sources of electromagnetic interference are known to affect the performance of both DBS pulse generators and ICD/pacemakers, 1, 7, 9, 11, 22, 24 but the risk of interference between DBS devices and ICDs is unknown. We report on a patient with bilateral STN stimulators in whom an ICD was subsequently implanted. Case Report History This 71-year-old right-handed man presented to a community hospital with chest discomfort and near syncope. He had a history of ischemic cardiomyopathy, coronary artery bypass surgery, congestive heart failure

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Morten Andresen, Marianne Juhler and Ole Cornelius Thomsen

interference: a device-device interaction . Pacing Clin Electrophysiol 33 : 994 – 998 , 2010 7 Lapinsky SE , Easty AC : Electromagnetic interference in critical care . J Crit Care 21 : 267 – 270 , 2006 8 Lee S , Fu K , Kohno T , Ransford B , Maisel WH : Clinically significant magnetic interference of implanted cardiac devices by portable headphones . Heart Rhythm 6 : 1432 – 1436 , 2009 9 Snijders J , de Bruijn P , Bergmans M , Bastianen G : Study on causes and prevention of electrostatic charge build-up during extracorporeal

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Rupesh Kotecha, Camille A. Berriochoa, Erin S. Murphy, Andre G. Machado, Samuel T. Chao, John H. Suh and Kevin L. Stephans

have metallic electrode leads that are implanted deep in the brain. Exposure to both sets of components can lead to separate, but clinically important risks to the patient. Exposure of the neurostimulator device to ionizing radiation or any electromagnetic interference may result in a range of side effects from minor patient discomfort to direct tissue damage and brain injury. This may be due to a minor change in stimulation output from the pulse generator, or in more serious circumstances, changes in the device memory and control circuitry (Activa Deep Brain

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Gene H. Barnett, Allan H. Ropper and Keith A. Johnson

clinical evaluation. Patients who are at risk of neurological deterioration should be withdrawn from the magnet between image acquisitions for clinical assessment. Also, imaging should be limited to the minimum sequences required to assess the patient's problem. In the event of an emergency, patients can be removed from the bore of the magnet in less than 10 seconds. Evoked potential monitoring may provide earlier warning of neurological deterioration than raised ICP; 6 however, image distortion due to electrode artifact and electromagnetic interference with the

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Filippo Agnesi, Susannah J. Tye, Jonathan M. Bledsoe, Christoph J. Griessenauer, Christopher J. Kimble, Gary C. Sieck, Kevin E. Bennet, Paul A. Garris, Charles D. Blaha and Kendall H. Lee

oxidized in a similar manner as at the glutamate sensor, producing an amperometric signal. For both in vitro and electrically evoked release in vivo, the applied potential was set to values indicated by the manufacturers of each sensor (+0.5 and +0.6 V for adenosine and glutamate, respectively). In Vitro Testing of the WINCS-Based FPA Analysis of Electromagnetic Interference To evaluate the susceptibility of WINCS-based FPA recordings to electromagnetic interference, measurements were collected by the WINCS and compared with those obtained simultaneously with

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Christoph J. Griessenauer, Su-Youne Chang, Susannah J. Tye, Christopher J. Kimble, Kevin E. Bennet, Paul A. Garris and Kendall H. Lee

-to-digital conversion of the recorded signal near the point of acquisition, combined with digital telemetry, enhances signal quality and provides enhanced immunity to electromagnetic interference. This capability for WINCS to support chemical measurements outside the faraday cage, which is typically required by conventional hard-wired devices to block ambient noise, makes this device functional in an operating room setting. 2 , 7 The WINCS can also transmit data to a remotely located base station, so, coupled with its small size, it does not contribute to crowding in the busy

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Thomas C. Chen, Gina R. Napolitano, Frank Adell, Axel H. Schönthal and Yehoshua Shachar

higher risk of occlusion. However, this inflow lumen features a port where external saline can be injected to unplug the catheter, thereby greatly reducing the risk of catheter occlusion. Potential pump failure may result from malfunctions in the communication, fluid path, and control components, or the catheter. A communication malfunction may result from a number of causes, such as electromagnetic interference, failure of the wireless Internet connection, disconnected antenna, or the device being out of range, which could cause cessation of communication or reduced

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Daniel R. Kramer, Casey H. Halpern, Dana L. Buonacore, Kathryn R. McGill, Howard I. Hurtig, Jurg L. Jaggi and Gordon H. Baltuch

planned trajectory, microelectrode recordings should commence. It is important to ensure that the microelectrode lead does not abut the dural edges, as any such migrational force can compromise targeting. The ground electrode attaches to the guide cannula, while the recording electrode attaches to the distal tip of the microelectrode. Turn off all the lights, suction device, electronic operating table, Bovie, and any other unnecessary forms of electromagnetic interference. Using the microdrive, slowly guide the microelectrode to the target depth. Take intermittent

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Michael Karsy, Hussam Abou-Al-Shaar, Christian A. Bowers and Richard H. Schmidt

catheter placement was performed with the aid of stereotactic guidance, with initial cases using AxiEM (Medtronic) navigation and later cases using the Stealth system with optical tracking PCI probe (Medtronic) and rigid head fixation. Initial cases with AxiEM were found to have suboptimal accuracy because of excessive electromagnetic interference from metallic components in the operative field, including the head holder and retractors. Separate right- and left-sided trajectories were planned from approximately Kocher’s point (1 cm anterior to the coronal suture in the