Operation of Implantable Cardiac Devices in Hyperbaric Conditions

Jacek Kot

doi:10.5772/intechopen.102659

Abstract

Implantable devices, including Implantable Cardiac Defibrillators (ICD) and Pacemakers (PM), are being seen with increasing frequency in patients wanting to conduct recreational diving or referred for Hyperbaric Oxygen Therapy (HBOT). Under hyperbaric conditions, these devices are at risk of malfunction, mostly by changes of ambient pressure. In some cases, manufacturers publish information on how their devices operate under increased pressure. Unfortunately, this is not always the case, and for other devices, someone must perform an individual risk-benefit analysis specific for single patient and his/her implanted device. In case of medical treatment, such analysis must take into account the patient’s clinical condition, the indication for HBOT, and the capability of the HBOT facility for monitoring and intervention in the chamber.

Highlights

The hyperbaric chamber is an active medical device, which is potentially hazardous taking into accounts its application and exposure of people inside to increased ambient pressure and increased partial pressure of oxygen
Regardless of using the monoplace chamber, where patient is left alone within the pressure vessel, or in multiplace chamber, where patient is staying in the larger internal space together with medical attendant, as with other patients, if so organized, in all cases, any medical device, either external to the patients or implanted, including Implantable Cardiac Defibrillators (ICD) and Pacemakers (PM), is exposed to increased ambient pressure
Use of other medical devices for therapeutic purpose in the hyperbaric chamber is related with additional hazards due to increased pressure, oxygen-enriched atmosphere, electricity, and confined space

Summary

Introduction

The hyperbaric chamber is an active medical device, which is potentially hazardous taking into accounts its application and exposure of people inside to increased ambient pressure and increased partial pressure of oxygen. Regardless of using the monoplace chamber, where patient is left alone within the pressure vessel, or in multiplace chamber, where patient is staying in the larger internal space together with medical attendant, as with other patients, if so organized, in all cases, any medical device, either external to the patients or implanted, including Implantable Cardiac Defibrillators (ICD) and Pacemakers (PM), is exposed to increased ambient pressure. Use of other medical devices for therapeutic purpose in the hyperbaric chamber is related with additional hazards due to increased pressure, oxygen-enriched atmosphere, electricity, and confined space. Medical providers often need to conduct themselves appropriate assessment of the medical equipment needed for continuation of intensive or general care during hyperbaric treatment

Risk management process

The practice

Conclusions