June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Suppression of electromagnetic interference in electroretinography from a patient with an implanted left ventricular assist device (LVAD)
Author Affiliations & Notes
  • Rebecca Schur
    Ophthalmic Research, Cleveland Clinic, Cleveland, Ohio, United States
  • Brendan Eck
    Imaging Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Alex Yuan
    Ophthalmic Research, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Rebecca Schur None; Brendan Eck None; Alex Yuan None
  • Footnotes
    Support  This study was supported in part by the NIH-NEI P30 Core Grant (IP30EY025585), Unrestricted Grants from The Research to Prevent Blindness, Inc., and Cleveland Eye Bank Foundation awarded to the Cole Eye Institute.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 768 – F0420. doi:
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    • Get Citation

      Rebecca Schur, Brendan Eck, Alex Yuan; Suppression of electromagnetic interference in electroretinography from a patient with an implanted left ventricular assist device (LVAD). Invest. Ophthalmol. Vis. Sci. 2022;63(7):768 – F0420.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : A left ventricular assist device (LVAD) is an implantable cardiac pump that uses a magnetically-levitating rotor to pump blood into circulation in patients with congestive heart failure. In a patient with an implanted LVAD, the high-frequency pump rotation introduces significant interference in electroretinography (ERG) recordings. We evaluate filtering methods to improve ERG quality in the presence of LVAD interference.

Methods : A patient with an implanted LVAD was referred for ERG testing on suspicion of a retinal dystrophy. Full-field ERG (ffERG) and pattern ERG (pERG) were performed according to ISCEV standards. Recordings were acquired in full-bandwidth mode and again in low-bandwidth mode. Digital low-pass and band-stop filtering were performed to mitigate ERG interference. Post-processing was also evaluated in a control subject with no implanted device.

Results : High-frequency interference corresponding to the speed of the pump was present in all recordings (Fig. 1). When applied in post-processing, both low-pass and band-stop filters suppressed the interference and presented readable ERGs without affecting peak times or amplitudes (Fig. 2). By contrast, when recording in low-BW mode, the filter drop-off was not steep enough to remove the interference and peak delays were introduced that could not be readily corrected.

Conclusions : LVAD interference in ERGs can be successfully removed using simple digital filters. If post-hoc data processing capabilities are unavailable, a large amount of interference can be suppressed with a lower acquisition bandwidth and additional recordings of each stimulus response.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Fig. 1 Representative light-adapted flash ERGs in time and frequency domains taken from (a-b) an LVAD patient and (c) a reference patient with no implanted device. Recordings show interference at (a) the baseline pump speed (*88.3Hz) and (b) the “artificial pulse” speeds (x55Hz, and ^121.7Hz).

Fig. 1 Representative light-adapted flash ERGs in time and frequency domains taken from (a-b) an LVAD patient and (c) a reference patient with no implanted device. Recordings show interference at (a) the baseline pump speed (*88.3Hz) and (b) the “artificial pulse” speeds (x55Hz, and ^121.7Hz).

 

Fig. 2 Representative filtering results applied to pattern ERGs. (a-b) Low-pass filters applied to ERGs acquired in full-bandwidth (Full-BW) and low-bandwidth (Low-BW) modes with a 40Hz cutoff frequency (---). (c-d) Bandstop filters applied to ERGs acquired in full-bandwidth (Full-BW) and low-bandwidth (Low-BW) modes. Three bandstop filters were applied in series with center frequencies at 55Hz, 88.3Hz, and 121.7Hz (---).

Fig. 2 Representative filtering results applied to pattern ERGs. (a-b) Low-pass filters applied to ERGs acquired in full-bandwidth (Full-BW) and low-bandwidth (Low-BW) modes with a 40Hz cutoff frequency (---). (c-d) Bandstop filters applied to ERGs acquired in full-bandwidth (Full-BW) and low-bandwidth (Low-BW) modes. Three bandstop filters were applied in series with center frequencies at 55Hz, 88.3Hz, and 121.7Hz (---).

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