Can transcranial magnetic stimulation damage or interact with implanted cardiac devices?

A last experiment revealed that a Biotronik Rivacor 5 VR-T Dx ICD, connected to a Medtronic Sprint Quattro Secure MRI SureScan 6947M dual-coil defibrillator lead and immersed in saline solution, stayed undamaged when it was programmed to a single-chamber mode and exposed to magnetic stimulation at an output of 70% of maximum and a repetition rate of 0.9 Hz for 15 minutes. Also, there was no change in the temperature of the saline bath.

"Our proof-of-principle experiments suggest that the risk of damage to an ICD and heating of an ICD may be low during magnetic stimulation, even when stimulation is delivered directly to the device," the researchers wrote.

"We consistently used a far greater output at a far closer distance to the ICD than would be realistic for TMS/TCMS [transcutaneous magnetic stimulation]."

They suggested that in light of the high comorbidity of depression in cardiovascular disease and its distinct effect on outcomes and prognosis, this might add therapeutic options for a significant proportion of cardiac patients.

"Our data could encourage investigators using TMS/TCMS to include device patients in future studies after careful individual risk/benefit analysis," they concluded.

They added that "Because only Biotronik ICD and Medtronic defibrillator leads were studied, research on pacemakers, ICD, and magnetic stimulation coils and generators of all types and manufacturers in more physiologic models of magnetic device interference is warranted."

Reference:

Wegner, F. K., Bietenbeck, M., Suntrup-Krueger, S., Markman, T. M., Eckardt, L., & Wolters, C. (2024). Transcranial/Transcutaneous Magnetic Stimulation Interacts With But Does Not Damage Implantable Cardioverter-Defibrillators. JACC: Clinical Electrophysiology. https://doi.org/10.1016/j.jacep.2023.10.021