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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 2024:10.1007/s10840-024-01777-z. [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] [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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Kewcharoen J, Shah K, Bhardwaj R, Contractor T, Turagam MK, Mandapati R, Lakkireddy D, Garg J. Electromagnetic Field-Induced Interactions Among Electric Vehicles, New-Generation Electronic Devices, and Cardiovascular Implantable Electronic Devices. JACC Clin Electrophysiol 2023; 9:257-259. [PMID: 36858694 DOI: 10.1016/j.jacep.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/20/2023]
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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: 0] [Impact Index Per Article: 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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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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