Effects of hyperbaric exposure on mechanical and electronic parameters of implantable cardioverter-defibrillators

Abstract Aims There is currently no adequate assessment of the mechanical and electronic alterations of implantable cardioverter-defibrillators (ICD) in hyperbaric conditions. As a result, many patients eligible for hyperbaric oxygen therapy cannot receive it if they are carrying an ICD, even in emergency situations. Hyperbaric oxygen therapy (HBOT) is the standard adjuvant treatment for life-threatening or disabling pathologies. Methods Twenty-two explanted ICDs of various brands and models were randomized in 2 groups: single hyperbaric exposure at an absolute pressure of 4,000 hPa and 30 iterative hyperbaric exposures at an absolute pressure of 4,000 hPa. Mechanical and electronic parameters of these ICDs were blindly assessed before, during and after hyperbaric exposures. Results Regardless of the hyperbaric exposure, we could not find any mechanical distorsion, inappropriate occurrence of tachytherapies, dysfunction of tachyarrhythmias therapeutic programming, or dysfunction of programmed parameters. Conclusion Dry hyperbaric exposure seems harmless on ICDs tested ex-vivo. This result may lead to a reassessment of the absolute contraindication of emergency HBOT to patients carrying an ICD. A real-life study in patients with ICD receiving HBOT should be performed to assess their tolerance to the treatment. Funding Acknowledgement Type of funding sources: None.