Case Report of the Safety Assessment of Transcranial Magnetic Stimulation Use in a Patient With Cardiac Pacemaker: To Pulse or Not to Pulse?
BACKGROUND
Single-pulse transcranial magnetic stimulation (sTMS) is an emerging neuromodulation method reported to be useful in migraine. Despite a low propensity for side effects, some concern with its use in patients with cardiac pacemakers has been expressed.


CASE
We present a patient with chronic migraine with a cardiac pacemaker, who had tried unsuccessfully several migraine preventives with either poor efficacy or tolerability. With involvement of the cardiology team, we tested the effect of sTMS on her pacemaker and found it to be a safe and effective option for her.


CONCLUSION
Having regard to the risk/benefit ratio of sTMS, its use in patients with disabling migraine in the presence of a cardiac pacemaker can be carefully evaluated and may represent a useful therapeutic option.
['Wei|Diana Y|DY|http://orcid.org/0000-0003-0644-7172', 'Greenwood|Fiona S|FS|', 'Murgatroyd|Francis D|FD|', 'Goadsby|Peter J|PJ|']
D000368:Aged D005260:Female D006801:Humans D008881:Migraine Disorders D010138:Pacemaker, Artificial D061214:Patient Safety D050781:Transcranial Magnetic Stimulation
transcranial magnetic stimulator pacemaker migraine