title: Extra-cardiac stimulators: what do cardiologists need to know?
abstract: For several decades, treating patients with pacemakers has been the privilege of cardiologists. However, in the last 30 years, researchers have found new targets for electrical stimulation in different clinical subspecialities, such as deep brain stimulation (for the treatment of Parkinson's disease, essential tremor, dystonia, and some psychiatric illnesses); spinal cord stimulation (for refractory angina, chronic pain, and peripheral artery disease); and sacral (for diverse urologic and proctologic conditions), vagal (for epilepsy), and phrenic nerve stimulation (for sleep apnoea). The purpose of this article is to familiarize cardiologists with these 'extra-cardiac pacemakers' and to discuss potential issues that must be addressed when these patients undergo cardiac procedures.
authors.affiliation: Division of Cardiology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Guinand
authors.affiliation: Division of Cardiology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Noble
authors.affiliation: Division of Cardiology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Angela
authors.initials: A
authors.lastname: Frei
authors.affiliation: Division of Urology, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Julien
authors.initials: J
authors.lastname: Renard
authors.affiliation: Division of Anaesthesiology, Geneva University Hospitals, Geneva, Switzerland Faculty of Medicine, Geneva University, Geneva, Switzerland.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Tramer
authors.affiliation: Division of Cardiology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland Faculty of Medicine, Geneva University, Geneva, Switzerland haran.burri@hcuge.ch.
authors.forename: Haran
authors.initials: H
authors.lastname: Burri
mesh_terms: D000072096:Cardiologists / Q000193:education*; D046690:Deep Brain Stimulation / Q000295:instrumentation; D017147:Defibrillators, Implantable; D004501:Education, Medical; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004562:Electrocardiography; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D058542:Implantable Neurostimulators; D008160:Lumbosacral Plexus; D008279:Magnetic Resonance Imaging; D010138:Pacemaker, Artificial; D061214:Patient Safety; D010791:Phrenic Nerve; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D062187:Spinal Cord Stimulation / Q000295:instrumentation; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000295:instrumentation
keywords: Deep brain stimulation; Neuromodulation; Pacemaker; Phrenic nerve stimulation; Sacral nerve stimulation; Spinal cord stimulation