What is the recommended approach if a patient has a pacemaker and requires treatment near the chest?

• A. Avoid treating the chest region; consider alternate sites or modalities; obtain physician clearance and monitor if exposure is necessary
• B. Proceed with treatment at normal chest sites
• C. Increase the intensity near chest
• D. Use only magnetic therapy near chest

Answer: (A)

When a patient has a pacemaker, any electrical or magnetic energy you apply near the chest can interfere with the device. The safest approach is to avoid the chest region altogether and treat other areas or use modalities that do not transmit energy through the chest. If exposure near the chest is ever considered, you must get clearance from the patient’s physician and carefully monitor the patient and the device before, during, and after the treatment.

This is best because the pacemaker relies on electrical signals to keep the heart rhythm, and external energy can cause inappropriate sensing or pacing inhibition, potentially leading to symptoms or rhythm changes. By using alternative treatment sites or non-contradicted modalities and ensuring medical oversight, you minimize the risk of device interference.

Choosing to proceed at the chest as usual, increasing the intensity near the chest, or relying on magnetic therapy near the chest all carry unnecessary risk of EMI affecting the pacemaker, so they’re not appropriate.