Question
Is it safe to perform ENGs on patients with a pacemaker?
Answer
First, let's clarify that we are using the term ENG (Electronystagmograpy) to describe electrode based vestibular tests, otherwise known as Electro-Oculography. There is no issue whatsoever in performing video goggles based vestibular tests (VNG/VOG-Videonystagmography) on patients with pacemakers.
Many vestibular labs offer the caution "ENG should not be used in individuals with pacemakers because the equipment may interfere with pacemaker function." I searched the literature for an explanation, found nothing specific, but did note that EKG electrodes are frequently used in patients with pacemakers. I called one of the country's most reputable clinics, and the director of the lab responded "Because ENG uses electrodes and is hooked to an amplifier, there is an outside possibility of reverse current transmission and I think this is the basis for the precaution of EOG and pacemakers. Of course, it's not an issue with VOG....."
Alan Desmond, Au.D. is the director of Blue Ridge Hearing and Balance Clinic in Bluefield and Princeton, WV, and is the author of Vestibular Function: Clinical and Practice Management, 2nd edition (Thieme, 2011).
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