Do media players cause interference with pacemakers?

High-power chargers for electric vehicles: are they safe for patients with pacemakers and defibrillators?

AIMS

Battery electric vehicle (BEV) sales and use are rapidly expanding. Battery electric vehicles, along with their charging stations, are a potential source of electromagnetic interference (EMI) for patients with cardiac implantable electronic devices (CIEDs). The new 'high-power' charging stations have the potential to create strong electromagnetic fields and induce EMI in CIEDs, and their safety has not been evaluated.

METHODS AND RESULTS

A total of 130 CIED patients performed 561 charges of four BEVs and a test vehicle (350 kW charge capacity) using high-power charging stations under continuous 6-lead electrocardiogram monitoring. The charging cable was placed directly over the CIED, and devices were programmed to maximize the chance of EMI detection. Cardiac implantable electronic devices were re-interrogated after patients charged all BEVs and the test vehicle for evidence of EMI. There were no incidences of EMI, specifically no over-sensing, pacing inhibition, inappropriate tachycardia detection, mode switching, or spontaneous reprogramming. The risk of EMI on a patient-based analysis is 0/130 [95% confidence interval (CI) 0%-2%], and the risk of EMI on a charge-based analysis is 0/561 (95% CI 0%-0.6%). The effective magnetic field along the charging cable was 38.65 µT and at the charging station was 77.9 µT.

CONCLUSIONS

The use of electric cars with high-power chargers by patients with cardiac devices appears to be safe with no evidence of clinically relevant EMI. Reasonable caution, by minimizing the time spent in close proximity with the charging cables, is still advised as the occurrence of very rare events cannot be excluded from our results.

Effects of external electrical and magnetic fields on pacemakers and defibrillators: from engineering principles to clinical practice

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.

Interference between active implanted medical devices and electromagnetic field emitting devices is rare but real: results of an incidence study in a population of physicians in France

BACKGROUND AND OBJECTIVE

Assessing the behavior of active implanted medical devices (AIMDs) in response to electromagnetic field (EMF) transmitters is a current issue of great importance. Given the numerous telecommunication systems and our lack of knowledge as to the impact of electromagnetic effects, this study investigated the reality of possible AIMD disturbance by EMFs by interviewing health professionals.

METHOD

A self-administered postal questionnaire was sent to almost 5,000 physicians in five specialties: cardiology; endocrinology; ears, nose, and throat; urology; and neurology. It collected data on the existence and annual number of incidents observed and the conditions under which they occurred, the EMF sources involved, and the means of managing the malfunctions.

RESULTS

A total of 1,188 physicians agreed to participate. Sixteen percent of participants reported cases of implant failure, three-quarters of whom, mainly in cardiology, reported rates of at least one incident per year-amounting to more than 100 incidents per year in all. Severity appeared to be moderate (discomfort or transient symptoms), but frequently required resetting or, more rarely, replacing the device. Some serious incidents were, however, reported. The sources implicated were basically of two types: electronic security systems (antitheft and airport gates) and medical electromagnetic radiation devices. These incidents were poorly reported within the public health system, preventing follow-up and effective performance of alert and surveillance functions.

CONCLUSION

Although minor, the risk of interference between EMF sources and AIMDs is real and calls for vigilance. It particularly concerns antitheft and airport security gates, though other sources may also cause incidents.

Electromagnetic interference and implanted cardiac devices: the nonmedical environment (part I)

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.