Medtronic DBS Mode D'emploi page 29

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Table 3. DBS System considerations for electrocautery (continued)
Device type
Activa RC
Activa SC
Laser procedures - Turn off the neurostimulator during laser procedures. Keep the laser
directed away from the neurostimulation system. Laser procedures may cause heating,
especially at the lead electrode site, resulting in tissue damage.
Additional EMI source examples: Conductive
Bone growth stimulators - Safety has not been established for the use of bone growth
stimulators on patients with an implanted DBS System. When using either an implantable
or external bone growth stimulator, make sure that both the bone stimulator and the
implanted DBS System are working as intended.
External defibrillators - If a patient requires external defibrillation, the first consideration
should be patient survival. Safety for the use of external defibrillatory discharges on
patients with implanted neurostimulation systems has not been established. External
defibrillation may damage a neurostimulator system or may cause tissue damage,
including brain tissue.
If external defibrillation is necessary, follow these precautions to minimize the current
flowing through the neurostimulator and lead system:
▪
Position defibrillation paddles as far from the neurostimulator as possible.
▪
Position defibrillation paddles perpendicular to the implanted neurostimulator-lead
system.
▪
Use the lowest clinically appropriate energy output (joules [watt seconds]).
Confirm neurostimulation system function following any external defibrillation.
Radio-frequency or microwave ablation - Safety has not been established for radio-
frequency (RF) or microwave ablation in patients who have an implanted neurostimulation
system. Induced electrical currents may cause heating, especially at the lead-electrode
site, resulting in tissue damage, including brain tissue.
Recording procedures - Safety has not been established for recording procedures using
equipment that generates electromagnetic interference (eg, electromyography,
electroencephalogram, or positron emission tomography) in patients with an implanted
DBS System.
Transcutaneous electrical nerve stimulation (TENS) - Do not place TENS electrodes
so that the TENS current passes over any part of the neurostimulation system. If patients
feel that the TENS may be interfering with the implanted neurostimulator, patients should
discontinue using the TENS until they talk with their doctor.
24 English Information for prescribers 2017-05-01
Considerations for electrocautery
▪
Turn off neurostimulator
▪
Turn off neurostimulator