Extra-cardiac stimulators: what do cardiologists need to know?

Europace. 2016 Sep;18(9):1299-307. doi: 10.1093/europace/euv453. Epub 2016 May 26.

Abstract

For several decades, treating patients with pacemakers has been the privilege of cardiologists. However, in the last 30 years, researchers have found new targets for electrical stimulation in different clinical subspecialities, such as deep brain stimulation (for the treatment of Parkinson's disease, essential tremor, dystonia, and some psychiatric illnesses); spinal cord stimulation (for refractory angina, chronic pain, and peripheral artery disease); and sacral (for diverse urologic and proctologic conditions), vagal (for epilepsy), and phrenic nerve stimulation (for sleep apnoea). The purpose of this article is to familiarize cardiologists with these 'extra-cardiac pacemakers' and to discuss potential issues that must be addressed when these patients undergo cardiac procedures.

Keywords: Deep brain stimulation; Neuromodulation; Pacemaker; Phrenic nerve stimulation; Sacral nerve stimulation; Spinal cord stimulation.

Publication types

  • Review

MeSH terms

  • Cardiologists / education*
  • Deep Brain Stimulation / instrumentation
  • Defibrillators, Implantable
  • Education, Medical
  • Electric Stimulation Therapy / adverse effects
  • Electric Stimulation Therapy / instrumentation*
  • Electric Stimulation Therapy / methods
  • Electrocardiography
  • Health Knowledge, Attitudes, Practice
  • Heart Diseases* / diagnosis
  • Heart Diseases* / physiopathology
  • Heart Diseases* / therapy
  • Humans
  • Implantable Neurostimulators*
  • Lumbosacral Plexus*
  • Magnetic Resonance Imaging
  • Pacemaker, Artificial
  • Patient Safety
  • Phrenic Nerve*
  • Predictive Value of Tests
  • Prosthesis Design
  • Prosthesis Failure
  • Reproducibility of Results
  • Risk Assessment
  • Risk Factors
  • Spinal Cord Stimulation / instrumentation
  • Treatment Outcome
  • Vagus Nerve Stimulation / instrumentation