Mental incapacity is a contraindication,because the patient must be able to adjust the patient programmer used to turn the stimulator on and off. In addition, the patient must be able to track and understand the response to therapy. Electromagnetic interference can result in injury to the patient from heating of the implanted components of the system, resulting in damage to the tissues. System damage may require surgical replacement. Operational changes to the neurostimulator from a magnetic source can potentially turn the system off, resulting in resumption of symptoms. This may require reprogramming. Unexpected changes in stimulation can result in a shock or jolt-type sensation. Sources of electromagnetic interference include defibrilla-tors, cardioverters, electrocautery, high-output ultrasonics or lithotripsy, magnetic resonance imaging and radiofre-quency, or microwave ablation. Use of magnetic resonance imaging and radiofrequency or microwave ablation can cause tissue damage.3 Diathermy, or energy from the diathermy (shortwave, microwave, or ultrasound) can be transferred through the implanted system and cause tissue damage at the site of the implanted electrodes. Diathermy is contraindicated in patients with InterStim.

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