Article contents
Top
Abstract
Introduction
Mechanisms of cardiac interaction
Arrhythmia risk and ECG-gating
Permanent pacemakers
ICD and CRT devices
Practical protocol
Contraindications
Conclusion
References
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Pacemakers, ICDs, arrhythmias, and the ECG-gating imperative
Author: Sameer Parmar, Prof Kemal Sarica, Mr. Daron Smith, Dr Pankaj Maheshwari
Article type: Clinical review and practical protocol
Topic: Shock wave lithotripsy, cardiac devices, rhythm safety
Extracorporeal shock wave lithotripsy can be considered in selected cardiac patients when appropriate pre-procedure assessment, ECG monitoring, ECG-gated shock delivery, and device-specific precautions are applied.
Patients with permanent pacemakers, implantable cardioverter-defibrillators, cardiac resynchronization therapy devices, atrial fibrillation, or ventricular ectopy require structured assessment rather than automatic exclusion. The central safety principle is to understand the interaction between shock waves, myocardial rhythm, and implanted cardiac device behavior.
The full article provides a practical clinical framework covering pacemakers, ICDs, CRT devices, atrial fibrillation, peri-procedural monitoring, contraindications, and decision-making for safe SWL planning.
Keywords: ESWL; shock wave lithotripsy; pacemaker; ICD; CRT; atrial fibrillation; ECG-gating; cardiac monitoring.