Interaction between cardiac pacemakers and deep brain stimulation pulse generators: Technical considerations

Deep brain stimulators and cardiac pacemakers are well established modalities for movement disorders and cardiac abnormalities respectively. Here, we report our experience with three patients who have cardiac pacemaker/implantable cardioverter defibrillator (ICD) implanted in another facility and presented with both cardiac and neurologic symptoms which required surgical intervention and repositioning of the deep brain stimulator generator. It is essential to keep both devices in separate compartments at a safe distance of more than 6 inches with appropriate programming parameters to avoid interference between the devices. Device interference may result in neurologic or cardiac sequel. DBS can be implanted safely in patients with cardiac pacemakers under strict vigilance.