Carlos Roncero1, Vartan Mardigyan2, Erik Service3, Julia Singerman4, Kayla Chennelle Whittaker5, Michal Friedman6, Howard Chertkow7. 1. Rotman Research Institute, Baycrest Health Science, Toronto, Canada; Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: tcroncero@gmail.com. 2. Dept. of Cardiology, Jewish General Hospital, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: vartan.mardigyan@mcgill.ca. 3. Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: erikwservice@gmail.com. 4. Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: juliasingerman@gmail.com. 5. Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: kaylachennelle@gmail.com. 6. Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: michalfaye@gmail.com. 7. Rotman Research Institute, Baycrest Health Science, Toronto, Canada; Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Chemin de la cote Sainte-Catherine, H3T 1E2, Montreal, Quebec, Canada. Electronic address: hchertkow@research.baycrest.org.
Abstract
BACKGROUND: Studies investigating the therapeutic applications of transcranial direct current stimulation (tDCS) in the treatment of age-related neurodegenerative disease have been promising. However, exclusion criteria for these studies invariably disqualify patients implanted with internal cardiac pacemakers, citing safety concerns. Because the majority of cardiac pacemaker implantees are over 65, this criterion may limit candidacy for tDCS based research and/or treatment of age-related neurodegenerative disease. OBJECTIVE/HYPOTHESIS: We will test the hypothesis that tDCS impacts pacemaker function. Strong electrical potentials, such as those generated by external defibrillators (∼500 V, ∼10 A), are known to occasionally damage pacemaker circuitry and software, but it seems unlikely tDCS would damage a pacemaker because it involves about 1/200th the energy (∼12 V, ∼2 mA) of an external defibrillator. METHODS: We delivered tDCS to seven participants (ages 70-92) with bipolar non-dependent pacemakers and subsequently collected data from the internal memory of the pacemakers to assess the tDCS signal detection, as well as alterations in mode switches, impedance levels, and pacing. Subsequently, similar assessments were carried out in participants who were pacemaker-dependent (ages 89-91). RESULTS: After a review of the recordings, it was found that tDCS had no impact on the non-dependant, as well as the dependent, pacemakers. There were zero mode switches nor any impact on impedance levels. CONCLUSION: Results in this small series of cases found no evidence that tDCS interferes with the function of the pacemakers and suggests tDCS can be delivered to patients equipped with a cardiac pacemaker. Further studies are needed to generalize these results to other pacemakers.
BACKGROUND: Studies investigating the therapeutic applications of transcranial direct current stimulation (tDCS) in the treatment of age-related neurodegenerative disease have been promising. However, exclusion criteria for these studies invariably disqualify patients implanted with internal cardiac pacemakers, citing safety concerns. Because the majority of cardiac pacemaker implantees are over 65, this criterion may limit candidacy for tDCS based research and/or treatment of age-related neurodegenerative disease. OBJECTIVE/HYPOTHESIS: We will test the hypothesis that tDCS impacts pacemaker function. Strong electrical potentials, such as those generated by external defibrillators (∼500 V, ∼10 A), are known to occasionally damage pacemaker circuitry and software, but it seems unlikely tDCS would damage a pacemaker because it involves about 1/200th the energy (∼12 V, ∼2 mA) of an external defibrillator. METHODS: We delivered tDCS to seven participants (ages 70-92) with bipolar non-dependent pacemakers and subsequently collected data from the internal memory of the pacemakers to assess the tDCS signal detection, as well as alterations in mode switches, impedance levels, and pacing. Subsequently, similar assessments were carried out in participants who were pacemaker-dependent (ages 89-91). RESULTS: After a review of the recordings, it was found that tDCS had no impact on the non-dependant, as well as the dependent, pacemakers. There were zero mode switches nor any impact on impedance levels. CONCLUSION: Results in this small series of cases found no evidence that tDCS interferes with the function of the pacemakers and suggests tDCS can be delivered to patients equipped with a cardiac pacemaker. Further studies are needed to generalize these results to other pacemakers.