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September 11, 1987

ESWL Now Possible for Patients With Pacemakers

JAMA. 1987;258(10):1284. doi:10.1001/jama.1987.03400100018004

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NEWS FOR PERSONS with kidney stones who wear pacemakers—heretofore considered a contraindication for undergoing extracorporeal shock wave lithotripsy (ESWL)—came in preliminary reports at two recent meetings.

At the annual meeting of the American College of Cardiology in New Orleans, Jonathan Langberg, MD, University of California, San Francisco, reported that he and colleagues tested 22 single-chamber pacemakers using 16 different models. The group didn't test any of the dual-chamber or motion-sensitive devices.

Each pacemaker was suspended in the lithotriptor's water bath, with both the pulse generator and electrode positioned 5 cm from the point of highest pressure (that is, right where the patient's kidney stones would be). The pacemakers were subjected to 50 to 75 shocks—synchronized with the pulsing—and monitored continuously. None of the 22 pacemakers was damaged by the lithotriptor, and only one malfunctioned slightly. "Based on this study [which will be published in the September issue of Pace], we