TENS and Pacemaker

RehabEdge Physical Therapy Forum

Forums Register Login Forgot Login? My Profile
My Subscription My Forums Photo Gallery Member List
Search Calendars FAQ Ticket List Log Out

TENS and Pacemaker

Logged in as: Guest

Users viewing this topic: none

Printable Version

All Forums >> [RehabEdge Forum] >> Open Forum >> TENS and Pacemaker

Page: [1]

Message

<< Older Topic Newer Topic >>

TENS and Pacemaker - August 28, 2004 9:38:00 AM

InOrbit

Posts: 30
Joined: September 15, 2003
Status: offline

Does anyone know of studies contra-indicating TENS as a mode of pain relief for the lower extremity in a patient with a pace maker?

If there is no study available , would you do a TENS treatment for a localised area on the lower extremity(eg. hip or knee)in such a patient ?

Post #: 1

Re: TENS and Pacemaker - August 28, 2004 12:50:00 PM

jma

Posts: 2432
Joined: August 24, 2000
From: NY
Status: offline

Hello,
Here are a few articles you can look at and see what the literature says:

1: Crevenna R, Stix G, Pleiner J, Pezawas T, Schmidinger H, Quittan M, Wolzt M.
Electromagnetic interference by transcutaneous neuromuscular electrical stimulation in patients with bipolar sensing implantable cardioverter defibrillators: a pilot safety study.
Pacing Clin Electrophysiol. 2003 Feb;26(2 Pt 1):626-9.
PMID: 12710324 [PubMed - indexed for MEDLINE]

2: Pyatt JR, Trenbath D, Chester M, Connelly DT.
The simultaneous use of a biventricular implantable cardioverter defibrillator (ICD) and transcutaneous electrical nerve stimulation (TENS) unit: implications for device interaction.
Europace. 2003 Jan;5(1):91-3.
PMID: 12504647 [PubMed - indexed for MEDLINE]

3: Chen D, Philip M, Philip PA, Monga TN.
Cardiac pacemaker inhibition by transcutaneous electrical nerve stimulation.
Arch Phys Med Rehabil. 1990 Jan;71(1):27-30. Erratum in: Arch Phys Med Rehabil 1990 May;71(6):388.
PMID: 2136990 [PubMed - indexed for MEDLINE]

4: Rasmussen MJ, Hayes DL, Vlietstra RE, Thorsteinsson G.
Can transcutaneous electrical nerve stimulation be safely used in patients with permanent cardiac pacemakers?
Mayo Clin Proc. 1988 May;63(5):443-5.
PMID: 3258950 [PubMed - indexed for MEDLINE]

5: Eriksson M, Schuller H, Sjolund B.
Hazard from transcutaneous nerve stimulation in patients with pacemakers.
Lancet. 1978 Jun 17;1(8077):1319. No abstract available.
PMID: 78088 [PubMed - indexed for MEDLINE]

JMA

(in reply to InOrbit)

Post #: 2

Re: TENS and Pacemaker - August 28, 2004 9:32:00 PM

Yen

Posts: 25
Joined: May 13, 2004
From: Australia
Status: offline

my understanding is that u need clearance from the cardiologist if you wanted to use TENs if you have a pacemaker. Tell me otherwise if that is the case.

(in reply to InOrbit)

Post #: 3

Re: TENS and Pacemaker - August 29, 2004 4:38:00 AM

mcap56

Posts: 619
Joined: October 26, 2002
From: New York, NY
Status: offline

TENS is contraindicated in patients with pacemakers but like many of the modalities contraindications, it may or may not be valid. As TENS forms a circuit, the question is can any electricity from the circuit travel accross the skin and end up near the pace maker. Unlikely but hard to say.

The real question you should ask here is what benefits do you expect to gain from using TENS on the knee? I would not expect much benefit so I would avoid it in this situation.

-mcap

(in reply to InOrbit)

Post #: 4

Re: TENS and Pacemaker - August 29, 2004 11:20:00 AM

InOrbit

Posts: 30
Joined: September 15, 2003
Status: offline

Thank you everybody for your replies.
JMA> The links you posted were very useful. I am reproducing them for everyone's benefit.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3258950

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2136990

I personally found the abstract description by Rasmussen et al more useful if you like to consider TENS for a patient with a co-existing back/knee / hip condition that warrants pain relief.This study clearly mentions what sites were used in the study . However studies by Chen D.et al also mention the need for monitoring .

http://www.fac.org.ar/tcvc/llave/c016/hayes.htm
ANother detailed link which deserves a reading I think.
Hope this topic was helpful to all as it was to me.

(in reply to InOrbit)

Post #: 5

Re: TENS and Pacemaker - August 30, 2004 5:56:00 AM

Dr.Wagner

Posts: 1242
Joined: January 24, 2003
From: Indianapolis
Status: offline

My advice would be this:
1. Contact cardiology (they won't know what TENS is though)
2. You will be just fine, pacemakers have wires in the ventricles of the heart, no TENS will have any effect on that.

_____________________________

Dr. Wagner DO
Moderator of Medical Complexity Forum

(in reply to InOrbit)

Post #: 6