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Magnet for adjusting permanent pacemaker or ICD

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Magnet Use

  • Can be used in an emergency under direct consultation with the on-call pacemaker physiologist Ph. 021 808 605 or cardiac consultant.
  • The magnet affects all devices differently and magnet position can be very specific. This information will be given to you when you phone the on-call pacemaker physiologist.

Indication for Magnet use in Permanent Pacemakers

The pacemaker will asynchronously pace at manufacturer specific rates

  • Can be used to suppress external interference where pacemaker is inhibited by noise causing pauses (eg sensing muscle tremor)
  • Can be used in some cases to increase pacing rate ( dependent on the brand of the pacemaker)

Indication for Magnet use in Internal Cardiac Defibrillators (ICD's)

  • Can be used to inhibit shocks (eg. patient is receiving inappropriate shocks due to a fractured lead)
  • Can inhibit appropriate shock during a VT storm (e.g. child very distressed by multiple shocks during a VT storm). Shocks can sometimes worsen the VT storm, with shocks delivered while the child is conscious, which increases stress and can sustain the VT storm. In these instances, the magnet can be used to suppress the ICD shock, allow child to lose consciousness (from VT), then remove magnet to allow child to receive another shock while unconscious, or when needed appropriately.

Process

  • The on-call cardiac physiologist MUST be contacted prior to using the magnet on Ph: 021 808 605
  • Individual patient resuscitation sheet available at bedside
  • Patient is monitored throughout (cardiac and respiratory monitoring)
  • Place the magnet on the skin directly over the pacemaker site (Application of magnet is only ever in direct consultation with pacemaker physiologist or cardiac consultant)
  • Pacemaker /ICD will revert to individual default settings which are manufacturer specific.
  • Call Code Pink or Code Blue as indicated

Location

  • Magnet is to be kept in the 23B Resuscitation trolley - drawer 3 "area specific equipment"

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Document Control

  • Date last published: 01 August 2016
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Cardiology
  • Owner: Jon Skinner
  • Editor: Marion Hamer
  • Review frequency: 2 years