In 2020 we set up a support group for people working or who have worked in the #NHS while living with #Parkinsons
This week we welcomed our 53rd member from around the UK 🇬🇧
Retweet to help us find more 🙏🏼
Watching @coldplay playing ‘Fix You’ with Michael J Fox was iconic
The lyrics are a poignant reminder of a journey with #Parkinsons. A call to governments to invest in more research so the scientific community to fix us. Thanks for the shout out at the end, I’m being good #cancer
Can you have deep brain stimulation if you have a cardiac pacemaker? YES. Are there potential pitfalls of DBS when a pacemaker in place? YES. Nice paper by Ha, Youn and colleagues where they particularly highlight the importance of pulse width and other settings in the newest issue of @MDCP_Journal.
Key Points:
- DBS in a person w/ cardiac implantable electronic devices has the potential to lead to electromagnetic interference.
- The inter-device distance in the chest/abdomen, the polarity of electrodes, and the amplitude of stimulation all matter.
- Severe interference could rarely lead to asynchronous pacing, increased ventricular pacing, or pacing inhibition.
- The authors systematically assessed the effect of modifying the amplitude, pulse width, frequency, and lead configuration of the DBS on the pacemaker.
- There was increased interference when 'changing the DBS parameter settings from bipolar to monopolar, increasing the frequency, and increasing the pulse width.'
- Ventricular over-sensing resulted when the pulse width was ramped up to 70–90 μs as shown in their figure below.
My take: First, those of you with cardiac pacemakers can get DBS devices, however seek out expert centers with experience in this area. The two batteries (one for cardiac and one for neuro) need to be implanted far enough away from each other to avoid interference. Once implanted it is possible for the two devices to affect one another, and that is why this report is important. What struck me about this case was the potential dose response relationship when increasing the width of the pulses delivered. Clinicians should be aware of this potential. One other trick we learned many years ago is that switching to bipolar stimulation may help when trying to obtain continuous cardiac monitoring during hospitalizations; especially if interference is encountered when wired with multiple monitoring devices. So, keep your eyes peeled for pacemaker artifacts coinciding with pulse width changes. Since the devices can talk to each other, hopefully the neurologist and cardiologist will also communicate for the benefit of the person implanted.
https://t.co/gQDeS4oECI #parkinson #deepbrainstimulation #dystonia
#Parkinsons putting research into practice & dubbed the ‘first of its kind in the world’ a Parkinson’s centre for integrated therapy has opened in Kent. https://t.co/s1xISPMFAK
Many people are curious about why exercise is so important for someone with PD. There are times when doing exercise or physical therapy doesn’t seem to be helping and is in fact causing fatigue or pain. What then? Read more on our blog!
https://t.co/NtEmXPQQHx