EEG Can Be Safely Performed in Patients with Pacemakers
Yes, electroencephalography (EEG) can be safely performed in patients with pacemakers without special precautions or device modifications. EEG is a diagnostic neurophysiologic test that records electrical brain activity and does not generate electromagnetic interference (EMI) that would affect pacemaker function.
Key Safety Considerations
Why EEG is Safe with Pacemakers
EEG does not generate EMI: Unlike procedures that produce electromagnetic interference (electrocautery, radiofrequency ablation, MRI), EEG is a passive recording technique that only detects electrical signals from the brain without emitting energy that could interfere with pacemaker function 1.
No evidence of device interference: Observational data from other diagnostic procedures demonstrate that medical devices used for recording electrical activity do not interfere with pacemaker function, and pacemakers do not interfere with the ability to capture diagnostic signals 1.
Manufacturer warnings lack clinical support: Although some device manufacturers list the presence of implanted electromedical devices as contraindications for certain procedures, there is little clinical evidence supporting restrictions for passive diagnostic tests like EEG 1.
Procedures That DO Require Precautions (For Context)
The following procedures generate significant EMI and require special management, which EEG does not:
- Electrocautery: Requires consideration of bipolar systems, short intermittent bursts, and possible device reprogramming 1.
- Radiofrequency ablation: Requires maintaining distance from pulse generator and leads 1.
- MRI: Generally contraindicated unless MRI-conditional device 1.
- Radiation therapy: Device must be outside radiation field 1.
Standard Monitoring Applies
Routine ECG monitoring: Continuous electrocardiographic monitoring should be performed as standard practice for any patient with a pacemaker undergoing medical procedures, which allows detection of any pacemaker or cardiac dysfunction 1.
No device reprogramming needed: Unlike procedures with significant EMI risk, there is no need to reprogram the pacemaker to asynchronous mode or disable rate-adaptive functions for EEG 1.
Clinical Bottom Line
Proceed with EEG without hesitation in pacemaker patients. The procedure poses no risk to device function and requires no special precautions beyond standard patient care and routine cardiac monitoring if clinically indicated 1.