Abstract
Purpose
To present a case of apparent interference of an ECG monitor by radiofrequency interference (RFI) and to provide a bnef review of RFI issues relevant to critical care medicine.
Clinical features
A 74-yr-old woman, with an implanted pacemaker, underwent major spinal surgery. In the post-anaesthesia care unit, the cardiac monitor demonstrated graphic evidence of pacemaker malfunction but there was no apparent effect on the patient. Investigation by the hospital’s biomedical personnel led to the conclusion that RFI was being interpreted by the monitor as abnormal pacemaker activity.
Conclusion
With the emergence of portable, battery-operated cominunication devices, there is an increased risk of RFI within hospitals. Antennas and repeaters are required to receive and boost the signal levels of these devices to improve signal quality. They are located throughout hospitals and may be situated near patient care areas. Patient monitors may receive these signals, misinterpret them as being patient-generated and output erroneous information. In the case described, the monitor was presented with RFI signals and interpreted them as pacemaker spikes, generating a tracing suggestive of pacemaker malfunction. Troubleshooting strategies and minimizing the potential impacts of RFI on patient monitors are discussed.
Résumé
Objectif
Présenter un cas d’interférence radiofréquentielle (IRF) apparue sur un moniteur ECG et passer brièvement en revue les problèmes de l’interférence radiofréquentielle en réanimation.
Éléments cliniques
Une femine de 74 ans porteuse d’un pacemaker implanté subissait une chirurgie rachidienne majeure. À l’unité des soins postanesthésiques, un enregistrement du moniteur cardiaque révélait un mauvais fonctionnement du pacemaker sans effet apparent sur la patiente. Un examen du personnel biomédical de l’hôpital permettait de conclure que l’IRF était interprétée comine une activité anormale du pacemaker.
Conclusion
L’apparition des instruments de cominunication portables alimentés par piles augmente le risque d’IRF à l’intérieur des hôpitaux. Dans le but d’améliorer la qualité des signaux, des antennes et des répéteurs sont utilisés pour recevoir et amplifier les signaux fournis par ces appareils. Ils sont localisés dans les hôpitaux et peuvent être situés près des secteurs de soins. Les moniteurs des patients peuvent capter ces signaux, les interpréter comine s’ils étaient générés par les patients et fournir ainsi de fausses informations. Dans le cas présent, le moniteur percevait des signaux d’IRF et les interprétait comine des pointes d’ECG, générant ainsi un tracé suggestif d’un dysfonctionnement de pacemaker. Les stratégies de détection et de correction destinées à minimiser les impacts potentiels de l’IRF sur les moniteurs font l’objet de la discussion.
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Cleland, M.J., Crosby, E.T. Electrocardiographic “pacemaker pseudospikes” and radio frequency interference. Can J Anaesth 44, 751–756 (1997). https://doi.org/10.1007/BF03013391
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DOI: https://doi.org/10.1007/BF03013391