Physiotherapy in patients with an implanted cardiac pacemaker

Włodzisław Kuliński

W. Kuliński – Physiotherapy in patients with an implanted cardiac pacemaker. FP 2017; 17(3); 28-36

 

Abstract

Background. In Poland, the number of patients with an implanted cardiac pacemaker equals over 100,000 and many of them undergo physical therapy and rehabilitation due to co-morbidities.
Material and methods. Sample electrocardiograms of various pacemaker pacing modes are presented. Cardiac pacemakers are sensitive to high-strength magnetic fields and electromagnetic fields generated by devices used in physical therapy.
Results. Short-wave diathermy may cause interference if the source of waves is located near the pacemaker site. Procedures using diathermy may inhibit pacemaker activity and cause heat damage to the generator (due to increased temperature). When a pulsed low-frequency magnetic field is used, the metal parts do not overheat, but there is a possibility of disturbances in the pacemaker function and thus it is recommended not to perform such procedures on the chest. The use of galvanic current, iontophoresis, and low and medium frequency currents is possible outside the area of the chest. There are no contraindications to light therapy and heat therapy. Electrical stimulation in patients with peripheral neuron damage may be used as long as special safety measures are followed.
The paper shows sample Holter monitor readings obtained when patients underwent various physical therapy procedures.
It also presents difficult cases of patients with an implanted cardiac pacemaker who require physical therapy and rehabilitation.
Conclusions. Most physical therapy procedures may be performed in patients with a pacemaker, but on condition that appropriate safety principles are followed.

Key words:
cardiac pacemaker, physiotherapy

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