question regarding pacemakers and death

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Specializes in Neuro ICU and Med Surg.

Last night at work we had a patient who we withdrew care because she was not doing well no matter what we did for her. She had a AICD. The doc wanted to place a magnent over it to stop it. I went to CICU (I work neuro ICU) and got the magnents for her. The doc placed the magnent over the AICD after the pt stopped breathing. How long does the AICD have to be exposed to the magnent before it stops? I am not sure how long the magnent has to be exposed before the AICD stopped.

I have no idea since caridac is not my strong suit. I have also never delt with this before.

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Specializes in Advanced Practice, surgery.

I understand that Implantable defibs stop immediately with magnets

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[ How long does the AICD have to be exposed to the magnent before it stops? I am not sure how long the magnent has to be exposed before the AICD stopped.]

I believe it stops immediately.

"The reason for this is because there is a small magnetically activated switch built into the electronics of pacemakers and implantable defibrillators. This internal switch is designed to close when a magnet of enough strength is placed over it. . . Removing the magnet returns the pacemaker or implantable defibrillator back to its previous, normal programming." (from Medtronic website)

Terri

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I spoke with our medtronic rep last week about this scenario. This is what he told me.

All the newer MEDTRONIC pacemakers have AICD components (he stressed that this was how medtronic devices worked, but he couldn't vouch for other brands).

If a pt has this AICD/pacer then we use the magnet to TURN OFF THE DEFIB aspect of the device so it won't shock pt - ie pt with runs of VTach but is being made comfort care (withdrawl/no shock). The magnet will flip a switch so the device can not read/respond to shockable rhythms. Once you remove the magnet the switch flips back and the device can shock.

But it WILL CONTINUE to pace. Magnet does not affect pacing ability. In our hospital our policy is to call the device rep and s/he comes in and turns off the pacemaker if that is needed (ie. withdrawing care).

Hope this helps.

Terri

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Specializes in CVICU, CCU, MICU, SICU, Transplant.
I spoke with our medtronic rep last week about this scenario. This is what he told me.

All the newer MEDTRONIC pacemakers have AICD components (he stressed that this was how medtronic devices worked, but he couldn't vouch for other brands).

If a pt has this AICD/pacer then we use the magnet to TURN OFF THE DEFIB aspect of the device so it won't shock pt - ie pt with runs of VTach but is being made comfort care (withdrawl/no shock). The magnet will flip a switch so the device can not read/respond to shockable rhythms. Once you remove the magnet the switch flips back and the device can shock.

But it WILL CONTINUE to pace. Magnet does not affect pacing ability. In our hospital our policy is to call the device rep and s/he comes in and turns off the pacemaker if that is needed (ie. withdrawing care).

Hope this helps.

Terri

That's true. We had a situation the other night with a patient that had a pacer/ICD who coded and expired. The doc placed a magnet to turn off the defib function but the pacer kept on firing and trying to capture despite the magnet. Called the EP fellow on-call and he said we'd have to contact the device manufacturer to send someone out to completely shut off the pacer.

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I spoke with our medtronic rep last week about this scenario. This is what he told me.

All the newer MEDTRONIC pacemakers have AICD components (he stressed that this was how medtronic devices worked, but he couldn't vouch for other brands).

If a pt has this AICD/pacer then we use the magnet to TURN OFF THE DEFIB aspect of the device so it won't shock pt - ie pt with runs of VTach but is being made comfort care (withdrawl/no shock). The magnet will flip a switch so the device can not read/respond to shockable rhythms. Once you remove the magnet the switch flips back and the device can shock.

But it WILL CONTINUE to pace. Magnet does not affect pacing ability. In our hospital our policy is to call the device rep and s/he comes in and turns off the pacemaker if that is needed (ie. withdrawing care).

Hope this helps.

Terri

I remmbered that one function was inhibited by the magnet, but the other was intact... Thanks for reminding me.

I have seen where eventually there are just pacer spikes that are not followed by a QRS.

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thats variable. Honestly I've seen the battery die off in less than 5 minutes. However a good 10 minutes will usually permanately deactivate a pacer and/or AICD

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