Interferências de aparelhos odontológicos em dispositivos cardíacos eletrônicos implantáveis.

Abstract

The implantable electronic cardiac devices (IECD’s) are artificial pacemakers, composed of a pulse generator and electrode leads, used in treating cardiac arrhythmias. Their main function is the detection of the heart’s intrinsic activity and, for this function, they are endowed with amplifier circuits that may amplify signals coming from sources of interference. The aim of this study was to evaluate if there is interference on the operation of IECD’s when they interact with dental devices. The study is a literature review, and the evidences were colected on databases PubMed, Science Direct, Scielo and Capes’ Periodical Portal; in portuguese, english, spanish and german. According to the findings, the monopolar electrocautery is the most common source of electromagnetic interference and of interaction on the IECD’s, where the most frequently encountered effects are the inhibition of pace on pacemakers and the inappropriate shock therapy on implantable cardioverter defibrillators. The use of ultrasonic scaler has been suggested as a source of electromagnetic interference, however, its use is controverse in the literature. Although the possibility of electromagnetic interference of electronic apex locators on IECD’s causes a big concern to the dentists, there are a number of studies that suggest that their use is safe. Other devices, commonly found at the dental office, as dental chair, dental x-ray, high and low speed engines, amalgamator, curin light, laser, electric toothbrush, electric pulp tester, guta-percha heat carrier and endodontics’s rotatory motors, do not seem to cause deleterious effect on IECD’s. It was possible to conclude that, even though there are old reports of electromagnetic interferences on IECD’s, most of the recent studies suggest little effect on cardiac devices function. However, caution is still needed to the safety of patients and dentist carrying IECD’s.