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Kewcharoen J, Shah K, Bhardwaj R, Contractor T, Turagam MK, Mandapati R, Lakkireddy D, Garg J. New-generation electronic appliances and cardiac implantable electronic devices: a systematic literature review of mechanisms and in vivo studies. J Interv Card Electrophysiol 2024; 67:1709-1720. [PMID: 38443707 DOI: 10.1007/s10840-024-01777-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Cardiac implantable electronic device (CIED) functions are susceptible to electromagnetic interference (EMI) from electromagnetic fields (EMF). Data on EMI risks from new-generation electronic appliances (EA) are limited. OBJECTIVE We performed a systematic literature review on the mechanisms of EMI, current evidence, and recently published trials evaluating the effect of EMF on CIEDs from electric vehicles (EV), smartphone, and smartwatch technology and summarize its safety data. METHODS Electronic databases, including PubMed and EMBASE, were searched for in vivo studies evaluating EMF strength and incidence between CIEDs and commercial EVs, new-generation smartphones, and new-generation smartwatches. RESULTS A total of ten studies (three on EVs, five on smartphones, one on smartphones, one on smartphones and smartwatches) were included in our systematic review. There was no report of EMI incidence associated with EVs or smartwatches. Magnet-containing smartphones (iPhone 12) can cause EMI when placed directly over CIEDs - thereby triggering the magnet mode; otherwise, no report of EMI was observed with other positions or smartphone models. CONCLUSION Current evidence suggests CIED recipients are safe from general interaction with EVs/HEVs, smartphones, and smartwatches. Strictly, results may only be applied to commercial brands or models tested in the published studies. There is limited data on EMI risk from EVs wireless charging and smartphones with MagSafe technology.
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Affiliation(s)
- Jakrin Kewcharoen
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Kuldeep Shah
- Division of Cardiology, Cardiac Arrhythmia Service, MercyOne Siouxland Heart and Vascular Center, Sioux City, IA, USA
| | - Rahul Bhardwaj
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Tahmeed Contractor
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Mohit K Turagam
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ravi Mandapati
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | | | - Jalaj Garg
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA.
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Strik M, Ploux S, van der Zande J, Velraeds A, Fontagne L, Haïssaguerre M, Bordachar P. The Use of Electrocardiogram Smartwatches in Patients with Cardiac Implantable Electrical Devices. SENSORS (BASEL, SWITZERLAND) 2024; 24:527. [PMID: 38257619 PMCID: PMC10818505 DOI: 10.3390/s24020527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/02/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024]
Abstract
Unlimited access to ECGs using an over-the-counter smartwatch constitutes a real revolution for our discipline, and the application is rapidly expanding to include patients with cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs) and implantable cardioverter defibrillators (ICDs). CIEDs require periodic evaluation and adjustment by healthcare professionals. In addition, implanted patients often present with symptoms that may be related to their PMs or ICDs. An ECG smartwatch could reveal information about device functioning, confirm normal device function, or aid in the case of device troubleshooting. In this review, we delve into the available evidence surrounding smartwatches with ECG registration and their integration into the care of patients with implanted pacemakers and ICDs. We explore safety considerations and the benefits and limitations associated with these wearables, drawing on relevant studies and case series from our own experience. By analyzing the current landscape of this emerging technology, we aim to provide a comprehensive overview that facilitates informed decision-making for both healthcare professionals and patients.
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Affiliation(s)
- Marc Strik
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France; (S.P.); (M.H.); (P.B.)
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
| | - Sylvain Ploux
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France; (S.P.); (M.H.); (P.B.)
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
| | - Joske van der Zande
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
- Cardiovascular and Respiratory Physiology, Twente University, 7522 NB Enschede, The Netherlands
| | - Anouk Velraeds
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
- Cardiovascular and Respiratory Physiology, Twente University, 7522 NB Enschede, The Netherlands
| | - Leslie Fontagne
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France; (S.P.); (M.H.); (P.B.)
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
| | - Michel Haïssaguerre
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France; (S.P.); (M.H.); (P.B.)
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
| | - Pierre Bordachar
- Cardio-Thoracic Unit, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France; (S.P.); (M.H.); (P.B.)
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F-33600 Pessac-Bordeaux, France; (J.v.d.Z.); (A.V.)
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Prasertwitayakij N, Komolmis T, Gunaparn S, Pisespongsa C, Phrommintikul A, Wongcharoen W, Nantsupawat T. Electromagnetic interference from automobile passive keyless entry in cardiovascular implantable electronic devices. Expert Rev Med Devices 2023; 20:973-977. [PMID: 37668539 DOI: 10.1080/17434440.2023.2255126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/06/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION The automobile passive keyless entry (PKE) system is a potential source of electromagnetic interference (EMI). We aim to determine the incidence and significance of EMI from automobile PKE system in cardiovascular implantable electronic device (CIED) patients. METHODS This was a single-center cross-sectional study conducted at Maharaj Nakorn Chiang Mai hospital, Thailand. Patients with CIED were instructed to lock and unlock two automobiles using the PKE system. Any EMI or arrhythmias were detected by CIED interrogation and single-lead electrocardiogram event recorder. We also used a spectrum analyzer to identify the automobiles working frequency bandwidth. RESULTS There was a total of 102 CIED patients. Device types included 48.0% defibrillators, 37.3% permanent pacemakers, and 14.7% cardiac resynchronization therapy device. Both interrogated data from device and event monitor revealed no incidence of EMI during the PKE activation. We failed to identify the working frequency bandwidth of the two studied cars due to very low signal strength, thus blended in with the background noise. CONCLUSIONS Automobile PKE systems transmitted very low power signals. Therefore, under normal circumstances, CIED patients can use automobile PKE system safely without any EMI regardless of key fob positions in relation to the CIED pulse generator. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (https://clinicaltrials.gov), and the identification number is NCT03016390.
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Affiliation(s)
- Narawudt Prasertwitayakij
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Taradol Komolmis
- Department of Electrical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
| | - Siriluck Gunaparn
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Cheeranun Pisespongsa
- Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Arintaya Phrommintikul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wanwarang Wongcharoen
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Teerapat Nantsupawat
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Saha N, Millward JM, Herrmann CJJ, Rahimi F, Han H, Lacour P, Blaschke F, Niendorf T. High-Fidelity 3D Stray Magnetic Field Mapping of Smartphones to Address Safety Considerations with Active Implantable Electronic Medical Devices. SENSORS (BASEL, SWITZERLAND) 2023; 23:1209. [PMID: 36772249 PMCID: PMC9919430 DOI: 10.3390/s23031209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Case reports indicate that magnets in smartphones could be a source of electromagnetic interference (EMI) for active implantable medical devices (AIMD), which could lead to device malfunction, compromising patient safety. Recognizing this challenge, we implemented a high-fidelity 3D magnetic field mapping (spatial resolution 1 mm) setup using a three-axis Hall probe and teslameter, controlled by a robot (COSI Measure). With this setup, we examined the stray magnetic field of an iPhone 13 Pro, iPhone 12, and MagSafe charger to identify sources of magnetic fields for the accurate risk assessment of potential interferences with AIMDs. Our measurements revealed that the stray fields of the annular array of magnets, the wide-angle camera, and the speaker of the smartphones exceeded the 1 mT limit defined by ISO 14117:2019. Our data-driven safety recommendation is that an iPhone 13 Pro should be kept at least 25 mm away from an AIMD to protect it from unwanted EMI interactions. Our study addresses safety concerns due to potential device-device interactions between smartphones and AIMDs and will help to define data-driven safety guidelines. We encourage vendors of electronic consumer products (ECP) to provide information on the magnetic fields of their products and advocate for the inclusion of smartphones in the risk assessment of EMI with AIMDs.
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Affiliation(s)
- Nandita Saha
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
| | - Jason M. Millward
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
| | - Carl J. J. Herrmann
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany
- Department of Physics, Humboldt University of Berlin, 10117 Berlin, Germany
| | - Faezeh Rahimi
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany
- Chair of Medical Engineering, Technische Universität Berlin, 10623 Berlin, Germany
| | - Haopeng Han
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany
| | - Philipp Lacour
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum, 13353 Berlin, Germany
| | - Florian Blaschke
- Department of Cardiology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum, 13353 Berlin, Germany
| | - Thoralf Niendorf
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin Ultrahigh Field Facility (B.U.F.F.), 13125 Berlin, Germany
- Experimental and Clinical Research Center (ECRC), A Joint Cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, 13125 Berlin, Germany
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Nowak B, Przibille O, Napp A. [Electromagnetic interference : Pacemakers, cardiac resynchronization therapy devices, implantable cardioverter-defibrillator]. Herzschrittmacherther Elektrophysiol 2022; 33:297-304. [PMID: 35781834 DOI: 10.1007/s00399-022-00875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
Patients with cardiac pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy devices (CRT) are exposed to different types of electromagnetic interference (EMI) at home and at work. Due to the constantly increasing role of electrically active appliances in daily use and the introduction of new therapy concepts such as the leadless cardiac pacemaker and the subcutaneous defibrillator, this topic is of great relevance. The further development of the implanted devices and the almost complete use of bipolar leads has reduced the overall risk of EMI. This review article provides information about the current status of possible interference in the private environment and how to avoid it. In addition, information is provided on how to deal with occupational sources of interference.
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Affiliation(s)
- Bernd Nowak
- Cardioangiologisches Centrum Bethanien, Im Prüfling 23, 60389, Frankfurt a.M., Deutschland.
| | - Oliver Przibille
- Cardioangiologisches Centrum Bethanien, Im Prüfling 23, 60389, Frankfurt a.M., Deutschland
| | - Andreas Napp
- Medizinische Klinik I, - Kardiologie, Angiologie und Internistische Intensivmedizin, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
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6
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Psenakova Z, Smondrk M, Barabas J, Benova M, Brociek R, Wajda A, Kowol P, Coco S, Sciuto GL. Computational Analysis of a Multi-Layered Skin and Cardiac Pacemaker Model Based on Neural Network Approach. SENSORS (BASEL, SWITZERLAND) 2022; 22:6359. [PMID: 36080817 PMCID: PMC9459797 DOI: 10.3390/s22176359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
The presented study discusses the possible disturbing effects of the electromagnetic field of antennas used in mobile phones or WiFi technologies on the pacemaker in the patient's body. This study aims to obtain information on how the thickness of skin layers (such as the thickness of the hypodermis) can affect the activity of a pacemaker exposed to a high-frequency electromagnetic field. This study describes the computational mathematical analysis and modeling of the heart pacemaker inserted under the skin exposed to various electromagnetic field sources, such as a PIFA antenna and a tuned dipole antenna. The finite integration technique (FIT) for a pacemaker model was implemented within the commercially available CST Microwave simulation software studio. Likewise, the equations that describe the mathematical relationship between the subcutaneous layer thickness and electric field according to different exposures of a tuned dipole and a PIFA antenna are used and applied for training a neural network. The main output of this study is the creation of a mathematical model and a multilayer feedforward neural network, which can show the dependence of the thickness of the hypodermis on the size of the electromagnetic field, from the simulated data from CST Studio.
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Affiliation(s)
- Zuzana Psenakova
- Department of Electromagnetic and Biomedical Engineering, Faculty of Electrical Engineering, University of Zilina, Univerzitna 1, 01026 Zilina, Slovakia
| | - Maros Smondrk
- Department of Electromagnetic and Biomedical Engineering, Faculty of Electrical Engineering, University of Zilina, Univerzitna 1, 01026 Zilina, Slovakia
| | - Jan Barabas
- Department of Electromagnetic and Biomedical Engineering, Faculty of Electrical Engineering, University of Zilina, Univerzitna 1, 01026 Zilina, Slovakia
| | - Mariana Benova
- Department of Electromagnetic and Biomedical Engineering, Faculty of Electrical Engineering, University of Zilina, Univerzitna 1, 01026 Zilina, Slovakia
| | - Rafał Brociek
- Department of Mathematics Applications and Methods for Artificial Intelligence, Faculty of Applied Mathematics, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Agata Wajda
- Institute of Energy and Fuel Processing Technology, 41-803 Zabrze, Poland
| | - Paweł Kowol
- Department of Mechatronics, Silesian University of Technology, Akademicka 10a, 44-100 Gliwice, Poland
| | - Salvatore Coco
- Department of Electrical, Electronics and Informatics Engineering, University of Catania, Viale Andrea Doria 6, 95125 Catania, Italy
| | - Grazia Lo Sciuto
- Department of Mechatronics, Silesian University of Technology, Akademicka 10a, 44-100 Gliwice, Poland
- Department of Electrical, Electronics and Informatics Engineering, University of Catania, Viale Andrea Doria 6, 95125 Catania, Italy
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7
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Vanneman M, Kothari P, Bodmer NJ, Convissar D, Desai GA, Kumar N, Iyer MH, Neuburger PJ, Essandoh MK, Cronin B, Dalia AA. The Year in Electrophysiology: Selected Highlights from 2021. J Cardiothorac Vasc Anesth 2022; 36:1526-1539. [DOI: 10.1053/j.jvca.2022.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/11/2022]
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Nadeem F, Tran CT, Torbey E, Philbin D, Morales C, Wu M. Interference by Modern Smartphones and Accessories with Cardiac Pacemakers and Defibrillators. Curr Cardiol Rep 2022; 24:347-353. [PMID: 35084671 PMCID: PMC8979866 DOI: 10.1007/s11886-022-01653-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/25/2022]
Abstract
Purpose of Review The risk of cardiac implantable electronic device (CIED) interference from cell phones was previously thought to be low based on older studies. Current generation of smartphones have incorporated more magnets for optimization of wireless charging, attachment of accessories, and convenience functionalities. These magnets have the potential to cause CIEDs to inadvertently revert into magnet mode. The purpose of this review is to summarize recent findings on smartphones and their accessories causing interference on CIEDs. Recent Findings Recent reports have demonstrated that the iPhone 12 series and accessories have the capability to cause CIED magnetic interference. Summary Current generation of smartphones, smartwatches, wireless headphones, and accessories have the potential to cause CIEDs to revert into magnet mode in both in vivo and ex vivo experiments. The risk of a clinically significant event is unlikely as long as the Food and Drug Administration (FDA) recommendations are followed; keeping smartphones and accessories at least six inches away from CIEDs.
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Affiliation(s)
- Fahd Nadeem
- Division of Cardiology, Department of Medicine, Lifespan Cardiovascular Institute and Brown University, Providence, RI, USA
| | - Cao Thach Tran
- Division of Cardiology, Department of Medicine, Lifespan Cardiovascular Institute and Brown University, Providence, RI, USA
| | - Estelle Torbey
- Division of Cardiology, Department of Medicine, Lifespan Cardiovascular Institute and Brown University, Providence, RI, USA
| | - Daniel Philbin
- Division of Cardiology, Department of Medicine, Lifespan Cardiovascular Institute and Brown University, Providence, RI, USA
| | - Carlos Morales
- Division of Cardiology, Department of Medicine, Lifespan Cardiovascular Institute and Brown University, Providence, RI, USA
| | - Michael Wu
- Division of Cardiology, Department of Medicine, Lifespan Cardiovascular Institute and Brown University, Providence, RI, USA.
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Rahimpour S, Kiyani M, Hodges SE, Turner DA. Deep brain stimulation and electromagnetic interference. Clin Neurol Neurosurg 2021; 203:106577. [PMID: 33662743 PMCID: PMC8081063 DOI: 10.1016/j.clineuro.2021.106577] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 01/08/2023]
Abstract
Deep brain stimulation (DBS) has evolved into an approved and efficacious treatment for movement, obsessive-compulsive, and epilepsy disorders that are refractory to medical therapy, with current investigation into other disease conditions. However, there are unintentional and intentional sources of external electromagnetic interference (EMI) that can lead to either malfunctioning or damaged DBS devices, as well as injury to human tissue. Comprehensive studies and guidelines on such topics in the medical literature are scarce. Herein, we review the principles behind EMI, as well as the various potential sources of interference, both unintentional (e.g. stray EMI fields) and intentional (e.g. MRI scans, "brainjacking"). Additionally, we employ the Manufacturer and User Device Facility Experience (MAUDE) database to assess real-world instances of EMI (e.g., airport body scanners, magnetic resonance imaging (MRI), and electrosurgery) affecting DBS devices commonly implanted in the United States (US).
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Affiliation(s)
- Shervin Rahimpour
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
| | - Musa Kiyani
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Sarah E Hodges
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Dennis A Turner
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; Departments of Neurobiology and Biomedical Engineering, Duke University, Durham, NC USA
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10
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Han JK. Smartphones, Smartwatches, and CIED Patient Safety: So Far, So Good. JACC Clin Electrophysiol 2020; 6:1167-1170. [PMID: 32972553 DOI: 10.1016/j.jacep.2020.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Janet K Han
- Electrophysiology Section, Division of Cardiology, Department of Medicine, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA.
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11
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Lacour P, Parwani AS, Schuessler F, Hohendanner F, Heinzel FR, Trippel TD, Boldt LH, Pieske B, Blaschke F. Are Contemporary Smartwatches and Mobile Phones Safe for Patients With Cardiovascular Implantable Electronic Devices? JACC Clin Electrophysiol 2020; 6:1158-1166. [DOI: 10.1016/j.jacep.2020.04.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 11/26/2022]
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12
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Workers with Active Implantable Medical Devices Exposed to EMF: In Vitro Test for the Risk Assessment. ENVIRONMENTS 2019. [DOI: 10.3390/environments6110119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The occupational health and safety framework identifies workers with an active implantable medical device (AIMD), such as a pacemaker (PM) or an implantable defibrillator (ICD), as a particularly sensitive risk group that must be protected against the dangers caused by the interference of electromagnetic field (EMF). In this paper, we describe the results of in vitro testing/measurements performed according to the EN50527-2-1:2016 standard, for the risk assessment of employees with a PM exposed to three EMF sources: (1) An electrosurgical unit (ESU); (2) a transcranial stimulator (TMS); and (3) an arc welder. The ESU did not affect the PM behavior in any of the configurations tested. For the TMS and the arc welder, interference phenomena were observed in limited experimental configurations, corresponding to the maximum magnetic field coupling between the EMF source and the implant. The in vitro measurements presented can be considered an example of how the specific risk assessment for a worker with a PM can be performed, according to one of the methodologies proposed in the EN50527-2-1:2016, and can be used as scientific evidence and literature data for future risk assessments on the same EMF sources.
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13
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Miften M, Mihailidis D, Kry SF, Reft C, Esquivel C, Farr J, Followill D, Hurkmans C, Liu A, Gayou O, Gossman M, Mahesh M, Popple R, Prisciandaro J, Wilkinson J. Management of radiotherapy patients with implanted cardiac pacemakers and defibrillators: A Report of the AAPM TG-203 †. Med Phys 2019; 46:e757-e788. [PMID: 31571229 DOI: 10.1002/mp.13838] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/16/2019] [Accepted: 08/28/2019] [Indexed: 11/11/2022] Open
Abstract
Managing radiotherapy patients with implanted cardiac devices (implantable cardiac pacemakers and implantable cardioverter-defibrillators) has been a great practical and procedural challenge in radiation oncology practice. Since the publication of the AAPM TG-34 in 1994, large bodies of literature and case reports have been published about different kinds of radiation effects on modern technology implantable cardiac devices and patient management before, during, and after radiotherapy. This task group report provides the framework that analyzes the potential failure modes of these devices and lays out the methodology for patient management in a comprehensive and concise way, in every step of the entire radiotherapy process.
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Affiliation(s)
- Moyed Miften
- Task Group 203, Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Dimitris Mihailidis
- Task Group 203, University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, PA, 19104, USA
| | - Stephen F Kry
- Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Chester Reft
- Department of Radiation Oncology, University of Chicago, Chicago, IL, 60637, USA
| | - Carlos Esquivel
- Department of Radiation Oncology, UT Health Sciences Center, San Antonio, TX, 78229, USA
| | - Jonathan Farr
- Division of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - David Followill
- Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Coen Hurkmans
- Department of Radiotherapy, Catharina Hospital, Eindhoven, the Netherlands
| | - Arthur Liu
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Olivier Gayou
- Department of Radiation Oncology, Allegheny General Hospital, Pittsburg, PA, 15212, USA
| | - Michael Gossman
- Department of Radiation Oncology, Tri-State Regional Cancer Center, Ashland, KY, 41101, USA
| | - Mahadevappa Mahesh
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Richard Popple
- Department of Radiation Oncology, University of Alabama, Birmingham, AL, 35249, USA
| | - Joann Prisciandaro
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, 48109, USA
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Napp A, Kolb C, Lennerz C, Bauer W, Schulz-Menger J, Kraus T, Marx N, Stunder D. Elektromagnetische Interferenz von aktiven Herzrhythmusimplantaten im Alltag und im beruflichen Umfeld. DER KARDIOLOGE 2019. [DOI: 10.1007/s12181-019-0335-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mattei E, Censi F, Calcagnini G. Electrical Stun Gun and Modern Implantable Cardiac Stimulators. HEALTH PHYSICS 2019; 116:18-26. [PMID: 30489364 DOI: 10.1097/hp.0000000000000942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of the study is to investigate systematically the possible interactions between two types of stun guns and last-generation pacemakers and implantable defibrillators. Experimental measurements were performed on pacemakers and implantable defibrillators from five leading manufacturers, considering the effect of stun gun dart positioning, sensing modality, stun gun shock duration, and defibrillation energy level. More than 300 measurements were collected. No damage or permanent malfunction was observed in either pacemakers or implantable defibrillators. During the stun gun shock, most of the pacemakers entered into the noise reversion mode. However, complete inhibition of the pacing activity was also observed in some of the pacemakers and in all the implantable defibrillators. In implantable defibrillators, standard stun gun shock (duration 5 s) caused the detection of a shockable rhythm and the start of a charging cycle. Prolonged stun gun shocks (10-15 s) triggered the inappropriate delivery of defibrillation therapy in all the implantable defibrillators tested. Also in this case, no damage or permanent malfunction was observed. For pacemakers, in most cases, the stun guns caused them either to switch to the noise reversion mode or to exhibit partial or total pacing inhibition. For implantable defibrillators, in all cases, the stun guns triggered a ventricular fibrillation event detection. No risks resulted when the stun gun was used by a person wearing a pacemaker or an implantable defibrillator. This work provides novel and up-to-date evidence useful for the evaluation of risks to pacemaker/implantable defibrillator wearers due to stun guns.
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How Do Patients Understand Safety for Cardiac Implantable Devices? Importance of Postintervention Education. Rehabil Res Pract 2018; 2018:5689353. [PMID: 30034882 PMCID: PMC6035822 DOI: 10.1155/2018/5689353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/16/2018] [Accepted: 05/21/2018] [Indexed: 12/20/2022] Open
Abstract
Aim This study was designed to assess the effect of patient education on the knowledge of safety and awareness about living with cardiac implantable electronic devices (CIEDs) within the context of phase I cardiac rehabilitation. Methods The study was conducted with 28 newly implanted CIED patients who were included in “education group (EG)”. Patients were questioned with a survey about living with CIEDs and electromagnetic interference (EMI) before and 1 month after an extensive constructed interview. Ninety-three patients who had been living with CIEDs were included in the “without education group (woEG)”. Results Patients in EG had improved awareness on topics related to physical and daily life activities including work, driving, sports and sexual activities, EMI of household items, harmful equipment, and some of the medical devices in the hospital setting (p<0.05). Patients in EG gave significantly different percent of correct answers for doing exercise or sports, using the arm on the side of CIEDs, EMI of some of the household appliances, medical devices, and all of the harmful equipment compared to woEG (p<0.05). Conclusion It was demonstrated that a constructed education interview on safety of CIEDs and living with these devices within the context of phase I cardiac rehabilitation is important for improving the awareness of patients significantly. Thus, patients might achieve a faster adaptation to daily life and decrease disinformation and misperceptions and thus promote the quality of life after the device implantation.
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Chabin X, Taghli-Lamallem O, Mulliez A, Bordachar P, Jean F, Futier E, Massoullié G, Andonache M, Souteyrand G, Ploux S, Boirie Y, Richard R, Citron B, Lusson JR, Godet T, Pereira B, Motreff P, Clerfond G, Eschalier R. Bioimpedance analysis is safe in patients with implanted cardiac electronic devices. Clin Nutr 2018. [PMID: 29525512 DOI: 10.1016/j.clnu.2018.02.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS There is an increase in the number of patients worldwide with cardiac implantable electronic devices (CIEDs). Current medical practice guidelines warn against performing bioimpedance analysis (BIA) in this group of patients in order to avoid any electromagnetic interference. These recommendations restrict using the BIA in patients undergoing heart failure or with nutrition disorders in whom BIA could be of major interest in detecting peripheral congestion and to help guide treatment. The present study was conducted to evaluate whether BIA caused electromagnetic interference in patients having CIEDs. METHODS Patient enrollment was conducted during routine face-to-face consultations for scheduled CIEDs interrogations. Device battery voltage, lead impedance, pacing thresholds and device electrograms were recorded before and after each BIA measurement to detect any electromagnetic interference or oversensing. RESULTS A total of 200 patients were enrolled. During BIA, no significant changes in battery voltage, lead impedance or pacing thresholds were detected, nor were there any inappropriate over- or undersensing observed in intracardiac electrograms. Furthermore, 6- and 12-month follow-up did not reveal any changes in CIEDs. CONCLUSIONS This study shows no interference in patients equipped with CIEDs and suggests that BIA can be securely performed in these patients. Trial registered under the identifier NCT03045822.
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Affiliation(s)
- Xavier Chabin
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Ouarda Taghli-Lamallem
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Aurélien Mulliez
- CHU Clermont-Ferrand, Biostatistics Unit (Clinical Research and Innovation Direction), F-63000 Clermont-Ferrand, France
| | - Pierre Bordachar
- Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France
| | - Frédéric Jean
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Emmanuel Futier
- Department of Perioperative Medicine, Anesthesiology and Critical Care Medicine, Estaing Hospital, University Hospital of Clermont-Ferrand and CNRS, Inserm U1103, GreD, Clermont-Ferrand, France
| | - Grégoire Massoullié
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Marius Andonache
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Géraud Souteyrand
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Sylvain Ploux
- Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France
| | - Yves Boirie
- Nutrition Department, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Ruddy Richard
- Nutrition Department, CHU Clermont-Ferrand, F-63003 Clermont-Ferrand, France
| | - Bernard Citron
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Jean-R Lusson
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Thomas Godet
- Department of Perioperative Medicine, Anesthesiology and Critical Care Medicine, Estaing Hospital, University Hospital of Clermont-Ferrand and CNRS, Inserm U1103, GreD, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Biostatistics Unit (Clinical Research and Innovation Direction), F-63000 Clermont-Ferrand, France
| | - Pascal Motreff
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Guillaume Clerfond
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France
| | - Romain Eschalier
- Université Clermont Auvergne, Cardio Vascular Interventional Therapy and Imaging (CaVITI), Image Science for Interventional Techniques (ISIT), UMR6284, and CHU Clermont-Ferrand, Cardiology Department, F-63003 Clermont-Ferrand, France.
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Gohil UK, Parekh VV, Kinariwala N, Oza KM, Somani MC. Can active signals of cellphone interfere with electronic working length determination of a root canal in a dental clinic? An in vivo study. J Conserv Dent 2017; 20:170-173. [PMID: 29279620 PMCID: PMC5706317 DOI: 10.4103/jcd.jcd_252_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To evaluate the interference of active cellphones during electronic working length (EWL) determination of a root canal. Materials and Methods: Thirty patients requiring root canal treatment in the anterior teeth or premolars having single canal and mature apices were selected for this study. Working length determination was done using no. 15 K-file. Electronic apex locators ProPex Pixi and Root ZX mini were used for working length determination. Cellphones iPhone 6s and Xolo Q3000 were evaluated for their interference. The experiment was conducted in a closed room (9 feet × 9 feet). Working length was measured with no cellphone in the room, iPhone 6s in a calling mode, Xolo Q3000 in a calling mode, and Xolo Q3000 and iPhone 6s simultaneously in a calling mode. Stability of the readings was also determined for every condition. Statistical Analysis: The data were statistically analyzed using one-way ANOVA and paired t-test at 0.05 level of significance. Results: Results were not statistically significant. Conclusion: Within the limitations of the present study, cellphones do not interfere with the EWL determination.
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Affiliation(s)
- Umadevi Kiritsinh Gohil
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Vaishali V Parekh
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Niraj Kinariwala
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Kaushal M Oza
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Mona C Somani
- Department of Conservative Dentistry and Endodontics, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
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Hikage T, Nojima T, Fujimoto H. Active implantable medical device EMI assessment for wireless power transfer operating in LF and HF bands. Phys Med Biol 2016; 61:4522-36. [PMID: 27224201 DOI: 10.1088/0031-9155/61/12/4522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The electromagnetic interference (EMI) imposed on active implantable medical devices by wireless power transfer systems (WPTSs) is discussed based upon results of in vitro experiments. The purpose of this study is to present comprehensive EMI test results gathered from implantable-cardiac pacemakers and implantable cardioverter defibrillators exposed to the electromagnetic field generated by several WPTSs operating in low-frequency (70 kHz-460 kHz) and high-frequency (6.78 MHz) bands. The constructed in vitro experimental test system based upon an Irnich's flat torso phantom was applied. EMI test experiments are conducted on 14 types of WPTSs including Qi-compliant system and EV-charging WPT system mounted on current production EVs. In addition, a numerical simulation model for active implantable medical device (AIMD) EMI estimation based on the experimental test system is newly proposed. The experimental results demonstrate the risk of WPTSs emitting intermittent signal to affect the correct behavior of AIMDs when operating at very short distances. The proposed numerical simulation model is applicable to obtain basically the EMI characteristics of various types of WPTSs.
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Affiliation(s)
- Takashi Hikage
- Graduate School of Information Science and Technology, Hokkaido University, Kita14, Nishi9, Kita-ku, Sapporo, Hokkaido, Japan
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Corzani A, Ziacchi M, Biffi M, Allaria L, Diemberger I, Martignani C, Bratten T, Gardini B, Boriani G. Clinical management of electromagnetic interferences in patients with pacemakers and implantable cardioverter-defibrillators: review of the literature and focus on magnetic resonance conditional devices. J Cardiovasc Med (Hagerstown) 2016; 16:704-13. [PMID: 26313816 DOI: 10.2459/jcm.0000000000000301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The number of cardiac implantable electronic devices (CIEDs) has greatly increased in the last 10 years. Many electronic devices used in daily activities generate electromagnetic interferences (EMIs) that can interact with CIEDs. In clinical practice, it is very important to know the potential sources of EMIs and their effect on CIEDs in order to understand how to manage or mitigate them. A very important source of EMI is magnetic resonance (MR), which is considered nowadays the diagnostic gold standard for different anatomical districts. In this review, we focused on the effects of EMI on CIEDs and on the clinical management. Moreover, we made a clarification about MR and CIEDs.In patients with CIEDs, EMIs may cause potentially serious and even life-threatening complications (inappropriate shocks, device malfunctions, inhibition of pacing in pacemaker-dependent patients) and may rarely dictate device replacement. The association of inappropriate shocks with increased mortality highlights the importance of minimizing the occurrence of EMI. Adequate advice and recommendations about the correct management of EMIs in patients with CIEDs are required to avoid all complications during hospitalization and in daily life. Furthermore, the article focused on actual management about MR and CIEDs.
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Affiliation(s)
- Alessandro Corzani
- aDepartment of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, S.Orsola Malpighi University Hospital, Bologna, Italy bMedtronic Inc, Minneapolis, Minnesota, USA *These authors contributed equally to this work
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Ishida K, Fujioka T, Endo T, Hosokawa R, Fujisaki T, Yoshino R, Hirose M. Evaluation of Electromagnetic Fields in a Hospital for Safe Use of Electronic Medical Equipment. J Med Syst 2016; 40:46. [PMID: 26643076 DOI: 10.1007/s10916-015-0411-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
Abstract
Establishment of electromagnetic compatibility is important in use of electronic medical equipment in hospitals. To evaluate the electromagnetic environment, the electric field intensity induced by electromagnetic radiation in broadcasting spectra coming from outside the hospital was measured in a new hospital building before any patients visited the hospital and 6 months after the opening of the hospital. Various incoming radio waves were detected on the upper floors, with no significant difference in measured levels before and after opening of the hospital. There were no cellphone terminal signals before the hospital opened, but these signals were strongly detected at 6 months thereafter. Cellphone base stations signals were strongly detected on the upper floors, but there were no signals at most locations in the basement and in the center of the building on the lower floors. A maximum electrical intensity of 0.28 V/m from cellphone base stations (2.1 GHz) was detected at the south end of the 2nd floor before the hospital opened. This value is lower than the EMC marginal value for general electronic medical equipment specified in IEC 60601-1-2 (3 V/m). Therefore, electromagnetic interference with electronic medical equipment is unlikely in this situation. However, cellphone terminal signals were frequently detected in non-base station signal areas. This is a concern, and understanding signal strength from cellphone base stations at a hospital is important for promotion of greater safety.
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Affiliation(s)
- Kai Ishida
- Division of Healthcare Informatics, Faculty of Healthcare, Tokyo Healthcare University, Setagaya 3-11-3, Tokyo, 154-8568, Japan.
| | - Tomomi Fujioka
- Advanced Technology Development Section, Building Technology Development Department, Technology Center, Taisei Corporation, Nase-cho 344-1, Yokohama, 245-0051, Japan
| | - Tetsuo Endo
- Advanced Technology Development Section, Building Technology Development Department, Technology Center, Taisei Corporation, Nase-cho 344-1, Yokohama, 245-0051, Japan
| | - Ren Hosokawa
- Department of Medical Safety Engineering, School of Allied Health Science, Kitasato University, Kitasato 1-15-1, Sagamihara, 252-0373, Japan
| | - Tetsushi Fujisaki
- Environmental Survey Office, Shinbashi 3-7-7, Tokyo, 105-0004, Japan
| | - Ryoji Yoshino
- Environmental Survey Office, Shinbashi 3-7-7, Tokyo, 105-0004, Japan
| | - Minoru Hirose
- Department of Medical Safety Engineering, School of Allied Health Science, Kitasato University, Kitasato 1-15-1, Sagamihara, 252-0373, Japan
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Meyer P, Makhlouf AM, Mondouagne Engkolo LP, Trentaz F, Thibault R, Pichard C, Burri H. Safety of Bioelectrical Impedance Analysis in Patients Equipped With Implantable Cardioverter Defibrillators. JPEN J Parenter Enteral Nutr 2016; 41:981-985. [PMID: 26903305 DOI: 10.1177/0148607116633823] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Current guidelines warn of potential electromagnetic interferences (EMI) when using bioelectrical impedance analysis (BIA) to measure body composition in patients equipped with implantable cardioverter-defibrillators (ICDs). We aimed to test the occurrence of EMI in a setting where this risk was experimentally maximized. MATERIALS AND METHODS Outpatients scheduled for routine ICD controls simultaneously underwent a BIA measurement using an electrical current of 0.8 mAmp at frequencies from 5-100 kHz. ICD sensitivity levels were set to maximum levels while therapies were temporarily inactivated. The device electrograms were monitored in real time to detect sensed and/or visible EMI during BIA measurement. RESULTS A total of 63 patients equipped with single-chamber (n = 13), dual-chamber (n = 18), or biventricular (n = 32) ICDs from 5 major manufacturers were included. No EMI were detected by the ICDs in these patients, nor were any artifacts visualized during real-time electrogram recordings. CONCLUSION BIA can be safely performed in patients equipped with ICDs without cardiac monitoring. Current guidelines should be updated accordingly.
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Affiliation(s)
- Philippe Meyer
- 1 Cardiology Service, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Florence Trentaz
- 1 Cardiology Service, Geneva University Hospitals, Geneva, Switzerland
| | - Ronan Thibault
- 2 Nutrition Unit, Geneva University Hospitals, Geneva, Switzerland.,3 Nutrition Unit, Department of Endocrinology, Diabetology and Nutrition, CHU Rennes, Rennes, France
| | - Claude Pichard
- 2 Nutrition Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Haran Burri
- 1 Cardiology Service, Geneva University Hospitals, Geneva, Switzerland
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Burri H, Mondouagne Engkolo LP, Dayal N, Etemadi A, Makhlouf AM, Stettler C, Trentaz F. Low risk of electromagnetic interference between smartphones and contemporary implantable cardioverter defibrillators. Europace 2016; 18:726-31. [PMID: 26857191 DOI: 10.1093/europace/euv374] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/15/2015] [Indexed: 11/13/2022] Open
Abstract
AIMS Manufacturers of implantable cardioverter defibrillators (ICDs) recommend that cell phones be maintained at a distance of ∼15 cm from the implanted device in order to avoid risk of dysfunction due to electromagnetic interference (EMI). Data relating to this issue are outdated and do not reflect modern technology. Our aim was to evaluate whether EMI is still an issue with contemporary ICDs and smartphones. METHODS AND RESULTS Consecutive patients implanted with a wireless-enabled ICD were tested for potential interference with two models of recent 4G smartphones in conditions intended to maximize risk of EMI. A magnet effect (due to the phone speakers) was tested by placing the smartphones in the standby mode directly over the ICD generator. The presence of EMI artefacts on the real-time electrograms was evaluated by placing the smartphones in the standby, dialling, and operating modes directly over the generator casing and over the parasternal region in the vicinity of the ventricular lead. A total of 63 patients equipped with 29 different models of single, dual, or biventricular ICDs from five major manufacturers were included. None of the patients showed any evidence of interference with the smartphones during any of the 882 tests. CONCLUSION The risk of EMI between modern smartphones and contemporary ICDs is low. This is probably due to the filters incorporated in the ICDs and low emission by the phones, as well as the small size of the magnets in the smartphones tested. STUDY REGISTRATION NCT02330900 (http://www.clinicaltrials.gov).
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Affiliation(s)
- Haran Burri
- Cardiology Service, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, Geneva 1205, Switzerland
| | | | - Nicolas Dayal
- Cardiology Service, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, Geneva 1205, Switzerland
| | - Abdul Etemadi
- Cardiology Service, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, Geneva 1205, Switzerland
| | - Anne-Marie Makhlouf
- Cardiology Service, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, Geneva 1205, Switzerland
| | - Carine Stettler
- Cardiology Service, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, Geneva 1205, Switzerland
| | - Florence Trentaz
- Cardiology Service, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, Geneva 1205, Switzerland
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Sidhu P, Shankargouda S, Dicksit DD, Mahdey HM, Muzaffar D, Arora S. Evaluation of Interference of Cellular Phones on Electronic Apex Locators: An In Vitro Study. J Endod 2016; 42:622-5. [PMID: 26850688 DOI: 10.1016/j.joen.2015.12.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 12/19/2015] [Accepted: 12/30/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Use of mobile phone has been prohibited in many hospitals to prevent interference with medical devices. Electromagnetic radiation emitted from cellular phones might interfere with electronic working length determination. The purpose of this in vitro study was to evaluate the effect of a smart phone (Samsung Galaxy Note Edge) on working length determination of electronic apex locators (EALs) Propex II and Rootor. METHODS Fifteen intact, non-carious single-rooted teeth were decoronated at the cementoenamel junction. Visually, working length was determined by using a #15 K-file under stereomicroscope (×20). The effect of cellular phones on electronic working length (EWL) was determined under 2 experimental settings: (1) in a closed room with poor signal strength and (2) in a polyclinic set up with good signal strength and 5 conditions: (1) electronically, without cellular phone in room; (2) electronically, with cellular phone in physical contact with EAL; (3) electronically, with mobile phone in physical contact with EAL and in calling mode for a period of 25 seconds; (4) electronically, mobile phone placed at a distance of 40 cm from the EAL; and (5) electronically, mobile phone placed at a distance of 40 cm and in calling mode for a period of 25 seconds. The EWL was measured 3 times per tooth under each condition. Stability of the readings was scored from 1 to 3: (1) good stability, (2) stable reading after 1 attempt, and (3) stable reading after 2 attempts. The data were compared by using analysis of variance. RESULTS The EWL measurements were not influenced by the presence of cellular phone and could be determined under all experimental conditions. CONCLUSIONS Within the limitations of this study, it can be concluded that mobile phones do not interfere with the EWL determination.
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Affiliation(s)
- Preena Sidhu
- Faculty of Dentistry, SEGi University, Jalan Teknologi, Kota Damansara, Selangor, Malaysia.
| | - Swapnil Shankargouda
- KLE University VK Institute of Dental Sciences, Jawaharlal Nehru Medical College Campus, Karnataka, India
| | | | - Haydar Majeed Mahdey
- Faculty of Dentistry, SEGi University, Jalan Teknologi, Kota Damansara, Selangor, Malaysia
| | - Danish Muzaffar
- Faculty of Dentistry, SEGi University, Jalan Teknologi, Kota Damansara, Selangor, Malaysia
| | - Shelly Arora
- Faculty of Dentistry, SEGi University, Jalan Teknologi, Kota Damansara, Selangor, Malaysia
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Electromagnetic interference in implantable cardioverter defibrillators: present but rare. Clin Res Cardiol 2016; 105:657-665. [DOI: 10.1007/s00392-016-0965-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 01/19/2016] [Indexed: 11/25/2022]
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Bassen H, Mendoza G. Comparison of Injected and Radiated EMC Testing of Active Implanted Cardiac Medical Devices at the Boundary Frequency of 450 MHz. IEEE ELECTROMAGNETIC COMPATIBILITY MAGAZINE 2016; 5:64-70. [PMID: 28729924 PMCID: PMC5515299 DOI: 10.1109/memc.2016.7866236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We compared testing via radiated vs. injected susceptibility methods specified in the ISO 14117 standard for electromagnetic compatibility of implantable cardiac medical devices. Injected testing is specified at and below 450 MHz and radiated testing is specified at and above this boundary frequency. Experimental and computational studies were performed to determine voltages induced in a model of an implant. The device under test (DUT) was a model with a metal case (5.0 x 4.5 x 3.4 cm high) containing a diode detector and a fiber optic link plus an insulated wire simulating a unipolar lead. We evaluated induced voltage in the model for radiated versus injected testing. The voltage from experimental measurements agreed with computed values within ±1.4 dB or less. Radiated testing with 12.25 Watts delivered to the dipole specified in the standard induced the same voltage as the injected test requirement (14 Vp-p). This is in strong contrast to the specified radiated test power of 120 mW or even the optional worst-case radiated test level of 8 Watts. Lateral displacement of the dipole by 2 cm changed the voltage induced in the DUT by 20% or less. For depth changes below saline surface from 5 mm to 10 mm voltage variations were 12.5%. There is poor agreement (by a factor of 9.9 or more) for radiated vs. injected testing at the border frequency of 450 MHz separating the two methods. Our computational model can also be used at other frequencies and for EMC studies of other types of active implants that use the ISO14117 standard's radiated test method, such as neuro-stimulators.
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Affiliation(s)
- Howard Bassen
- Life Fellow IEEE, U. S. Food and Drug Administration Center for Devices and Radiological Health
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Napp A, Stunder D, Maytin M, Kraus T, Marx N, Driessen S. Are patients with cardiac implants protected against electromagnetic interference in daily life and occupational environment? Eur Heart J 2015; 36:1798-804. [DOI: 10.1093/eurheartj/ehv135] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 04/02/2015] [Indexed: 11/14/2022] Open
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Huang D, Dong ZF, Chen Y, Wang FB, Wei Z, Zhao WB, Li S, Liu MY, Zhu W, Wei M, Li JB. Interference of GSM mobile phones with communication between Cardiac Rhythm Management devices and programmers: A combined in vivo and in vitro study. Bioelectromagnetics 2015; 36:367-76. [PMID: 25864643 DOI: 10.1002/bem.21911] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 02/24/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Dong Huang
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Zhi-Feng Dong
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Yan Chen
- Department of Geratology; Shanghai People's Armed Police Corps Hospital; Shanghai China
| | - Fa-Bin Wang
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Zhi Wei
- St. Jude Medical; Shanghai China
| | | | - Shuai Li
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Ming-Ya Liu
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Wei Zhu
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Meng Wei
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
| | - Jing-Bo Li
- Division of Cardiology; the Sixth People's Hospital Affiliated to Shanghai Jiaotong University; Shanghai Jiaotong University School of Medicine; State Key Discipline Division; Shanghai China
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Sriman N, Prabhakar V, Bhuvaneswaran JS, Subha N. Interference of apex locator, pulp tester and diathermy on pacemaker function. J Conserv Dent 2015; 18:15-9. [PMID: 25657520 PMCID: PMC4313472 DOI: 10.4103/0972-0707.148868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 11/12/2014] [Accepted: 11/15/2014] [Indexed: 01/02/2023] Open
Abstract
Aim: The purpose of this study was to evaluate the effects of three electronic apex locators (EAL), electric pulp tester (EPT) and diathermy on pacemaker function in vitro. Materials and Methods: Three EALs: Root ZX (J. Morita Co., Tustin, CA, U.S.A.), Propex (Dentsply), Mini Apex locator (SybronEndo, Anaheim, CA, USA), EPT (Parkell pulp vitality tester Farmingdale, NY, USA) and Diathermy (Neomed 250 B) were tested for any interference with one pacemaker (A medtronic kappa KVDD901-serial number: PLE734632S). Directly connecting the pacemaker lead with the EAL/EPT/diathermy operating on a flat bench top, the telemetry wand was held directly over the pacemaker to monitor the pacing pattern for a period of 30 s. Pacemaker activity was continuously recorded on the telemetric programmer and electro gram (EGM) readings examined for pacer inhibition, noise reversion or inappropriate pacemaker pulses. Results: All the three apex locators showed no pacing interference or background noise during its function or at rest. The EGM readings of EPT showed varying levels of background noise in between pacing however, this did not affect the normal pacing pattern and the pacing interval remained constant. EGM readings of diathermy showed an increase in the pacing interval (irregular pacing pattern) followed by complete inhibition of the pacing system. Conclusion: The tested EALs do not interfere with cardiac pacemaker function. The tested EPT showed varying levels of background noise but does not interfere with cardiac pacemaker function. Use of Diathermy interfered with the normal pacing, leading to complete inhibition of the pacing system.
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Affiliation(s)
- Narayanan Sriman
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | - V Prabhakar
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | - J S Bhuvaneswaran
- Department of Cardiology, P.S. Govindasamy Naidu Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - N Subha
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
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Goldblatt JG, Krief I, Klonsky T, Haller D, Milloul V, Sixsmith DM, Srugo I, Potasman I. Use of Cellular Telephones and Transmission of Pathogens by Medical Staff in New York and Israel. Infect Control Hosp Epidemiol 2015; 28:500-3. [PMID: 17385162 DOI: 10.1086/513446] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Accepted: 07/06/2006] [Indexed: 11/04/2022]
Abstract
Hands and instruments used by healthcare workers may serve as vectors for the nosocomial transmission of microorganisms. The use of cellular telephones by medical personnel and the associated nosocomial transmission of pathogens have not been thoroughly examined. Findings from our study show that cellular telephones are commonly used by hospital personnel, even during patient contact. One-fifth of the cellular telephones examined in this study were found to harbor pathogenic microorganisms, showing that these devices may serve as vectors for transmission to patients.
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Technology in health care: forensic implications. Crit Care Nurs Q 2014; 38:49-80. [PMID: 25463007 DOI: 10.1097/cnq.0000000000000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Technology continues to evolve and improve making our everyday tasks appear sometimes routine and mundane. The health care industry has embraced technological advances to improve on its daily operations in an effort to run more efficiently. Health care providers must be aware that these technologies collect data, lots of data, which is discoverable and may be used to defend or refute your actions as a nurse. This article will take a closer look at health care technology, cell phones, medical equipment, social media, telematics, and Health Insurance Portability and Accountability Act requirements, so that you will become familiar with the information and electronic fingerprint left behind.
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Mattei E, Censi F, Triventi M, Calcagnini G. Electromagnetic immunity of implantable pacemakers exposed to wi-fi devices. HEALTH PHYSICS 2014; 107:318-325. [PMID: 25162422 DOI: 10.1097/hp.0000000000000113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study is to evaluate the potential for electromagnetic interference (EMI) and to assess the immunity level of implantable pacemakers (PM) when exposed to the radiofrequency (RF) field generated by Wi-Fi devices. Ten PM from five manufacturers, representative of what today is implanted in patients, have been tested in vitro and exposed to the signal generated by a Wi-Fi transmitter. An exposure setup that reproduces the actual IEEE 802.11b/g protocol has been designed and used during the tests. The system is able to amplify the Wi-Fi signal and transmits at power levels higher than those allowed by current international regulation. Such approach allows one to obtain, in case of no EMI, a safety margin for PM exposed to Wi-Fi signals, which otherwise cannot be derived if using commercial Wi-Fi equipment. The results of this study mitigate concerns about using Wi-Fi devices close to PM: none of the PM tested exhibit any degradation of their performance, even when exposed to RF field levels five times higher than those allowed by current international regulation (20 W EIRP). In conclusion, Wi-Fi devices do not pose risks of EMI to implantable PM. The immunity level of modern PM is much higher than the transmitting power of RF devices operating at 2.4 GHz.
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Affiliation(s)
- Eugenio Mattei
- *Department of Technology and Health, Italian National Institute of Health, Rome, Italy
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Health Implications of Electromagnetic Fields, Mechanisms of Action, and Research Needs. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/198609] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Electromagnetic fields (EMF) have been implicated to influence a range of bodily functions. Given their ubiquitous nature, widespread applications, and capability to produce deleterious effects, conclusive investigations of the health risks are critical. Accordingly, this paper has been constructed to weigh the bioeffects, possible biointeraction mechanisms, and research areas in bioelectromagnetics seeking immediate attention. The several gaps in the existing knowledge do not permit one to reach a concrete conclusion but possibility for harmful effects cannot be underestimated in absence of consistent findings and causal mechanisms. Several studies with appropriate methodologies reflect the capacity of electromagnetic radiations to cause adverse health effects and there are several credible mechanisms that can account for the observed effects. Hence, need of the hour is to activate comprehensive well-coordinated blind scientific investigations, overcoming all limitations and demerits of previous investigations especially replication studies to concretize the earlier findings. Furthermore, appropriate exposure assessment is crucial for identification of dose-response relation if any, and the elucidation of biological interaction mechanism. For the time being, the public should follow the precautionary principle and limit their exposure as much as possible.
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Beinart R, Nazarian S. Effects of external electrical and magnetic fields on pacemakers and defibrillators: from engineering principles to clinical practice. Circulation 2014; 128:2799-809. [PMID: 24366589 DOI: 10.1161/circulationaha.113.005697] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The overall risk of clinically significant adverse events related to EMI in recipients of CIEDs is very low. Therefore, no special precautions are needed when household appliances are used. Environmental and industrial sources of EMI are relatively safe when the exposure time is limited and distance from the CIEDs is maximized. The risk of EMI-induced events is highest within the hospital environment. Physician awareness of the possible interactions and methods to minimize them is warranted.
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Affiliation(s)
- Roy Beinart
- Section for Cardiac Electrophysiology, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD. (R.B., S.N.); and Davidai Arrhythmia Center, Leviev Heart Center, Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel (R.B.)
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Dyrda K, Khairy P. Implantable rhythm devices and electromagnetic interference: myth or reality? Expert Rev Cardiovasc Ther 2014; 6:823-32. [DOI: 10.1586/14779072.6.6.823] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Tondato F, Ng DW, Srivathsan K, Altemose GT, Halyard MY, Scott LR. Radiotherapy-induced pacemaker and implantable cardioverter defibrillator malfunction. Expert Rev Med Devices 2014; 6:243-9. [DOI: 10.1586/erd.09.7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Morioka I, Tabuchi Y, Takahashi Y, Oda Y, Nakai M, Yanase A, Watazu C. [Bacterial contamination of mobile phones shared in hospital wards and the consciousness and behavior of nurses about biological cleanliness]. Nihon Eiseigaku Zasshi 2013; 66:115-21. [PMID: 21358142 DOI: 10.1265/jjh.66.115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The purpose of this study was to clarify the contamination of mobile phones shared in hospital wards and its relationship with the consciousness and behavior of nurses about biological cleanliness. METHODS Samples from mobile phones were cultured to detect viable bacteria (n=110) and Staphylococcus aureus (n=54). A questionnaire survey was conducted on 110 nurses carrying mobile phones on the day of sampling. RESULTS Viable bacteria were detected on 79.1% of the mobile phones, whereas S. aureus was detected on 68.6%. All the nurses were aware of hand washing with water or alcohol after regular work, but 33.6% of the nurses were not conscious of hand washing with water or alcohol after using a mobile phone. There was a significant positive relationship between the frequency of using mobile phones and the number of hand washings with water or alcohol. A significant negative relationship was found between the detection of viable bacteria and the number of hand washings with alcohol. The results of logistic regression analysis showed that the detection of viable bacteria was related significantly with the number of hand washings with alcohol (Odds ratio, 0.350; 95%CI, 0.143-0.857) and that the detection of S. aureus was related significantly with the frequency of using mobile phones (Odds ratio, 0.183; 95%CI, 0.036-0.933). CONCLUSIONS It is important to be conscious of the fact that mobile phones shared in hospital wards are easily contaminated. Because hand washing with water or alcohol prevents the contamination of the mobile phones, nurses should take standard precautions after using mobile phones.
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Affiliation(s)
- Ikuharu Morioka
- School of Health and Nursing Science, Wakayama Medical University, Japan.
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38
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Santini L, Forleo GB, Santini M. Implantable devices in the electromagnetic environment. J Arrhythm 2013. [DOI: 10.1016/j.joa.2013.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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OSTIGUY GENEVIÈVE, BLACK TOM, BLUTEAU LOUISJEAN, DUPONT LOUIS, DYRDA KATIA, GIRARD GUILLAUME, NGUYEN DUCHAI, PLANTE MICHEL, THIBAULT BERNARD. Smart Meters and Routers Radiofrequency Disturbances Study with Pacemakers and Implantable Cardiac Defibrillators. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 36:1417-26. [DOI: 10.1111/pace.12225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 05/07/2013] [Accepted: 06/03/2013] [Indexed: 11/28/2022]
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Shields N, Gormley J, O'Hare N. Contraindications To Continuous And Pulsed Short-wave Diathermy. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331902125002599] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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DORENKAMP MARC, BLASCHKE FLORIAN, VOIGT KATHLEEN, FLECK ECKART, GOETZE STEPHAN, ROSER MATTIAS. Electromagnetic Interference of Avalanche Transceivers with Cardiac Pacemakers and Implantable Cardioverter Defibrillators. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 36:931-8. [DOI: 10.1111/pace.12159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 02/17/2013] [Accepted: 02/25/2013] [Indexed: 11/29/2022]
Affiliation(s)
- MARC DORENKAMP
- Department of Cardiology, Charité - Universitätsmedizin Berlin; Campus Virchow-Klinikum; Berlin; Germany
| | - FLORIAN BLASCHKE
- Department of Cardiology, Charité - Universitätsmedizin Berlin; Campus Virchow-Klinikum; Berlin; Germany
| | - KATHLEEN VOIGT
- Department of Cardiology, Charité - Universitätsmedizin Berlin; Campus Virchow-Klinikum; Berlin; Germany
| | - ECKART FLECK
- Department of Internal Medicine/Cardiology; German Heart Institute Berlin; Berlin; Germany
| | - STEPHAN GOETZE
- Department of Internal Medicine/Cardiology; German Heart Institute Berlin; Berlin; Germany
| | - MATTIAS ROSER
- Department of Cardiology, Charité - Universitätsmedizin Berlin; Campus Virchow-Klinikum; Berlin; Germany
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Chaiban GM, Davidov M, Cummings JE, Lehrian LE, Yee EMY, Dugan A, Almualim MS, Atallah JN. The Cross-Talk Between Spinal Cord Stimulators and the Confirm™ Cardiac Monitor. Neuromodulation 2013; 17:42-7; discussion 47. [DOI: 10.1111/ner.12060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/08/2013] [Accepted: 03/18/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Jennifer Eiko Cummings
- Department of Internal Medicine; Division of Cardiology; University of Toledo Medical Center; Toledo OH USA
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Cronin EM, Gray J, Abi-Saleh B, Wilkoff BL, Levin KH. Safety of repetitive nerve stimulation in patients with cardiac implantable electronic devices. Muscle Nerve 2013; 47:840-4. [DOI: 10.1002/mus.23707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2012] [Indexed: 11/05/2022]
Affiliation(s)
- Edmond M. Cronin
- Department of Cardiovascular Medicine; Cleveland Clinic; Cleveland Ohio USA
| | - Jennifer Gray
- Department of Neurology; Neuromuscular Center/S90, Cleveland Clinic; Cleveland Ohio 44195 USA
| | - Bernard Abi-Saleh
- Department of Cardiovascular Medicine; Cleveland Clinic; Cleveland Ohio USA
| | - Bruce L. Wilkoff
- Department of Cardiovascular Medicine; Cleveland Clinic; Cleveland Ohio USA
| | - Kerry H. Levin
- Department of Neurology; Neuromuscular Center/S90, Cleveland Clinic; Cleveland Ohio 44195 USA
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Capsule Endoscopy in Patients with Implantable Electromedical Devices is Safe. Gastroenterol Res Pract 2013; 2013:959234. [PMID: 23710168 PMCID: PMC3654345 DOI: 10.1155/2013/959234] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 02/24/2013] [Indexed: 02/08/2023] Open
Abstract
Background and Study Aims. The presence of an implantable electromechanical cardiac device (IED) has long been considered a relative contraindication to the performance of video capsule endoscopy (CE). The primary aim of this study was to evaluate the safety of CE in patients with IEDs. A secondary purpose was to determine whether IEDs have any impact on images captured by CE. Patients and Methods. A retrospective chart review of all patients who had a capsule endoscopy at Mayo Clinic in Scottsdale, AZ, USA, or Rochester, MN, USA, (January 2002 to June 2010) was performed to identify CE studies done on patients with IEDs. One hundred and eighteen capsule studies performed in 108 patients with IEDs were identified and reviewed for demographic data, method of preparation, and study data. Results. The most common indications for CE were obscure gastrointestinal bleeding (77%), anemia (14%), abdominal pain (5%), celiac disease (2%), diarrhea (1%), and Crohn's disease (1%). Postprocedure assessments did not reveal any detectable alteration on the function of the IED. One patient with an ICD had a 25-minute loss of capsule imaging due to recorder defect. Two patients with LVADs had interference with capsule image acquisition. Conclusions. CE did not interfere with IED function, including PM, ICD, and/or LVAD and thus appears safe. Additionally, PM and ICD do not appear to interfere with image acquisition but LVAD may interfere with capsule images and require that capsule leads be positioned as far away as possible from the IED to assure reliable image acquisition.
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Radiofrequency identification: exploiting an old technology for measuring nurse time and motion. Comput Inform Nurs 2013; 30:463-72. [PMID: 22592451 DOI: 10.1097/nxn.0b013e3182545418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A national campaign is underway to increase the amount of time staff nurses spend at the bedside of hospitalized patients through redesign of the work environment. This kind of work redesign requires robust data depicting what nurses do and how they spend their time. Historically, these kinds of data have been difficult, costly, and time consuming to collect. Wireless capture of data on the movement of humans within the work environment (ie, time and motion) is now possible through radiofrequency identification technology. When small tracking devices the size of a quarter are affixed to their clothing, the movement of nurses throughout a patient care unit can be monitored. The duration and frequency of patient interaction are captured along with the duration of time spent in other locations of interest to include nurses' station, supply room, medication room, doctors' station, electronic documentation stations, family waiting rooms, and the hallway. Patterns of nurse movement and time allocation can be efficiently identified, and the effects of staffing practices, workflows, and unit layout evaluated. Integration of radiofrequency identification time and motion data with other databases enables nurse leaders to link nursing time to important cost and quality outcomes. Nurse leaders should explore the usefulness of radiofrequency identification technology in addressing data needs for nurse time and motion.
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Chung JW, Hwang HJ, Chung MJ, Park JY, Pak HN, Song SY. Safety of capsule endoscopy using human body communication in patients with cardiac devices. Dig Dis Sci 2012; 57:1719-1723. [PMID: 22311369 DOI: 10.1007/s10620-012-2067-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 01/17/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND The MiroCam (IntroMedic, Ltd., Seoul, Korea) is a small-bowel capsule endoscope that uses human body communication to transmit data. The potential interactions between cardiac devices and the capsule endoscope are causes for concern, but no data are available for this matter. AIM This clinical study was designed to evaluate the potential influence of the MiroCam capsules on cardiac devices. METHODS Patients with cardiac pacemakers or implantable cardiac defibrillators referred for evaluation of small bowel disease were prospectively enrolled in this study. Before capsule endoscopy, a cardiologist checked baseline electrocardiograms and functions of the cardiac devices. Cardiac rhythms were continuously monitored by 24-h telemetry during capsule endoscopy in the hospital. After completion of procedures, functions of the cardiac devices were checked again for interference. Images from the capsule endoscopy were reviewed and analyzed for technical problems. RESULTS Six patients, three with pacemakers and three with implantable cardiac defibrillators, were included in the study. We identified no disturbances in the cardiac devices and no arrhythmias detected on telemetry monitoring during capsule endoscopy. No significant changes in the programmed parameters of the cardiac devices were noted after capsule endoscopy. There were no imaging disturbances from the cardiac devices on capsule endoscopy. CONCLUSIONS Capsule endoscopy using human body communication to transmit data was safely performed in patients with cardiac pacemakers or implantable cardiac defibrillators. Images from the capsule endoscopy were not affected by cardiac devices. A further large-scale study is required to confirm the safety of capsule endoscopy with various types of cardiac devices.
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Affiliation(s)
- Joo Won Chung
- Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Misiri J, Kusumoto F, Goldschlager N. Electromagnetic interference and implanted cardiac devices: the nonmedical environment (part I). Clin Cardiol 2012; 35:276-80. [PMID: 22539305 DOI: 10.1002/clc.21998] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 03/19/2012] [Indexed: 12/13/2022] Open
Abstract
The number of patients with cardiovascular implantable electronic devices (CIEDs), such as permanent pacemakers and implantable cardioverter-defibrillators, is dramatically rising due to an aging population and recent clinical trials showing benefits in mortality and morbidity. Coupled with this increase in the number of patients with CIEDs is the proliferation of technology that emits electromagnetic signals, which can potentially interfere with CIED function through electromagnetic interference (EMI). Despite continuous efforts of manufacturers to create "EMI-proof" CIEDs, adverse events from EMI still occur. Physicians caring for patients with CIEDs should be aware of potential sources of EMI and appropriate management options. This 2-part review aims to provide a contemporary overview of the current knowledge regarding risks attributable to EMI interactions from the most common nonmedical (Part I) and medical (Part II) sources.
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Affiliation(s)
- Juna Misiri
- Department of Medicine, Division of Cardiovascular Disease, Electrophysiology and Pacing Service, Mayo Clinic, 4500 San Pablo Avenue, Jacksonville, FL 32224, USA
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Buch E, Bradfield J, Larson T, Horwich T. Effect of bioimpedance body composition analysis on function of implanted cardiac devices. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:681-4. [PMID: 22452409 DOI: 10.1111/j.1540-8159.2012.03377.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND It is routinely recommended that patients with pacemakers, implantable cardioverter defibrillators (ICD), and cardiac resynchronization therapy-defibrillators (CRT-D) avoid bioelectrical impedance analysis (BIA)--a commonly used method to estimate body composition--because of the concern for the potential for BIA interference with pacemaker or ICD function. However, the prevalence of such interference is not known. OBJECTIVE Assess for incidence of interference between BIA and ICD or CRT-D devices. METHODS AND RESULTS Twenty patients with heart failure and cardiac implanted electronic devices (50% ICD, 50% CRT-D) underwent BIA during real-time device interrogation to detect interference. Study patients were 90% male, with mean age 54 ± 14 years, and mean LVEF 23 ± 11%. Devices from all four leading cardiac device manufacturers were included. Device therapies were temporarily disabled to prevent inappropriate shocks. During body composition testing using BIA, no evidence of interference with ICD function was seen in any patient, including no telemetry disruption, no oversensing on any lead, and no patient symptoms. CONCLUSIONS Despite the manufacturers' recommendation to avoid BIA in patients with ICDs, this study showed no evidence of any interference in 20 patients. Bioimpedance analysis might be safe in such patients, but further confirmatory studies are required.
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Affiliation(s)
- Eric Buch
- UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
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Cuschieri JR, Osman MN, Wong RC, Chak A, Isenberg GA. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review. World J Gastrointest Endosc 2012; 4:87-93. [PMID: 22442746 PMCID: PMC3309898 DOI: 10.4253/wjge.v4.i3.87] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/01/2012] [Accepted: 03/01/2012] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).
METHODS: Authors conducted a chart review of 20 patients with a cardiac pacemaker (CP) or implantable cardioverter defibrillator (ICD) who underwent continuous electrocardiographic monitoring during their SBCE from 2003-2008. authors searched for unexplained electrocardiogram (ECG) findings, changes in CP and ICD set parameters, any abnormality in transmitted capsule data, and adverse clinical events.
RESULTS: There were no adverse events or hemodynamically significant arrhythmias reported. CP and ICD set parameters were preserved. The majority of ECG abnormalities were also found in pre- or post- SBCE ECG tracings and the CP behavior during arrhythmias appeared appropriate. Two patients seemed to have episodes of undersensing by the CP. However, similar findings were documented in ECGs taken outside the time frame of the SBCE. One patient was observed to have a low signal encountered from the capsule resulting in lack of localization, but no images were lost.
CONCLUSION: Capsule-induced EMI remains a possibility but is unlikely to be clinically important. CP-induced interference of SBCE is also possible, but is infrequent and does not result in loss of images transmitted by the capsule.
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Affiliation(s)
- Justin R Cuschieri
- Justin R Cuschieri, Division of Gastroenterology, Department of Medicine, Albert Einstein Medical Center, 5401 Old York Road, Klein building suite 363, Philadelphia, PA 19141, United States
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Tiikkaja M, Alanko T, Lindholm H, Hietanen M, Hartikainen J, Toivonen L. Experimental study on malfunction of pacemakers due to exposure to different external magnetic fields. J Interv Card Electrophysiol 2012; 34:19-27. [PMID: 22231158 DOI: 10.1007/s10840-011-9651-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 11/30/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE Cardiac pacemaker malfunction due to exposure to magnetic fields may cause serious problems in some work environments for workers having cardiac pacemakers. The aim of this study was to find the magnetic field interference thresholds for several commonly used pacemaker models. METHODS We investigated 16 pacemakers from three different manufacturers with the frequency range of 2 to 1,000 Hz, using sinusoidal, pulse, ramp, and square waveforms. The magnetic fields were produced by a computer-controlled Helmholtz coil system. RESULTS Pacemaker malfunction occurred in six of 16 pacemakers. Interaction developed almost immediately after high-intensity magnetic field exposure started. With each waveform, at least two pacemakers exhibited interference. In most exposure settings, there was no interference at magnetic field levels below the international occupational safety limits. Nevertheless, some frequencies using ramp or square waveforms interfered with pacemakers even at levels below public exposure limits. The occurrence of interference depended greatly on the waveform, frequency, magnetic field intensity, and the sensing configuration of the pacemaker. Unipolar configurations were more susceptible for interference than the bipolar ones. In addition, magnetic fields perpendicular to the pacemaker loops were more likely to cause interference than parallel fields. CONCLUSION There is a need for further investigations on pacemaker interference caused by different external magnetic fields to ensure safe working environment to workers with a pacemaker.
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Affiliation(s)
- Maria Tiikkaja
- Safe New Technologies, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
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