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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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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: 2.5] [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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Mattei E, Censi F, Calcagnini G, Falsaperla R. Workers with Cardiac AIMD Exposed to EMF: Methods and Case Studies for Risk Analysis in the Framework of the European Regulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189709. [PMID: 34574648 PMCID: PMC8470458 DOI: 10.3390/ijerph18189709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 01/24/2023]
Abstract
Workers with cardiac active implantable medical devices (AIMD), such as a pacemaker (PM) or an implantable defibrillator (ICD), are considered by the occupational health and safety regulation framework 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 first describe the general methodology that shall be followed for the risk assessment of employees with a cardiac AIMD exposed to EMF, according to the EU regulation, and in particular to the EN 50527-2-1:2016 and 50527-2-2:2018 standards. Then, three case studies related to specific EMF sources are presented, to better describe how the initial analysis of the risk assessment can be performed in practice, and to understand if a further specific risk assessment analysis is required or not.
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Affiliation(s)
- Eugenio Mattei
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, 00199 Rome, Italy; (F.C.); (G.C.)
- Correspondence:
| | - Federica Censi
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, 00199 Rome, Italy; (F.C.); (G.C.)
| | - Giovanni Calcagnini
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, National Institute of Health, 00199 Rome, Italy; (F.C.); (G.C.)
| | - Rosaria Falsaperla
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00078 Roma, Italy;
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Nadeem F, Nunez Garcia A, Thach Tran C, Wu M. Magnetic Interference on Cardiac Implantable Electronic Devices From Apple iPhone MagSafe Technology. J Am Heart Assoc 2021; 10:e020818. [PMID: 34074132 PMCID: PMC8477860 DOI: 10.1161/jaha.121.020818] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Magnet wireless charging is being utilized increasingly in current generation smartphones. Apple's MagSafe is a proprietary wireless charging technology with an array of magnets that has the capacity to generate magnet fieldstrength >50 gauss (G). We hypothesize that there is clinically significant magnet interference caused by Apple's MagSafe technology on cardiac implantable electronic devices (CIED). Methods and Results This study has an in vivo and an ex vivo component. The in vivo component consists of consecutive patients who presented to the electrophysiology laboratory with previously implanted CIEDs. The iPhone 12 Pro Max was directly placed on the skin over the pocket of these patients and the effect was studied by device interrogation. For the ex vivo component of the study, CIEDs from major device companies were tested for magnetic interference caused by iPhone 12 Pro Max through unopened packages. We found that iPhone 12 Pro Max resulted in clinically identifiable magnet interference in 3/3 (100%) participants in vivo and in 8/11 (72.7%) devices ex vivo. Conclusions Apple's iPhone 12 Pro Max MagSafe technology can cause magnet interference on CIEDs and has the potential to inhibit lifesaving therapy.
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Affiliation(s)
- Fahd Nadeem
- Division of Cardiology Department of Medicine Lifespan Cardiovascular Institute and Brown University Providence RI
| | - Arismendy Nunez Garcia
- Division of Cardiology Department of Medicine Lifespan Cardiovascular Institute and Brown University Providence RI
| | - Cao Thach Tran
- Division of Cardiology Department of Medicine Lifespan Cardiovascular Institute and Brown University Providence RI
| | - Michael Wu
- Division of Cardiology Department of Medicine Lifespan Cardiovascular Institute and Brown University Providence RI
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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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Effects of electromagnetic interference on the functional usage of medical equipment by 2G/3G/4G cellular phones: A review. J Adv Res 2016. [DOI: 10.1016/j.jare.2016.04.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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CURCIO ANTONIO, DE ROSA SALVATORE, SABATINO JOLANDA, DE LUCA SIMONA, BOCHICCHIO ANGELA, POLIMENI ALBERTO, SANTARPIA GIUSEPPE, RICCI PIETRANTONIO, INDOLFI CIRO. Clinical Usefulness of a Mobile Application for the Appropriate Selection of the Antiarrhythmic Device in Heart Failure. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:696-702. [DOI: 10.1111/pace.12872] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/29/2016] [Accepted: 04/07/2016] [Indexed: 01/15/2023]
Affiliation(s)
- ANTONIO CURCIO
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - SALVATORE DE ROSA
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - JOLANDA SABATINO
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - SIMONA DE LUCA
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - ANGELA BOCHICCHIO
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - ALBERTO POLIMENI
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - GIUSEPPE SANTARPIA
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - PIETRANTONIO RICCI
- Institute of Forensic Medicine, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
| | - CIRO INDOLFI
- Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia; Campus di Germaneto; Catanzaro Italy
- U.R.T.-C.N.R; Catanzaro Italy
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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: 3.4] [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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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: 92] [Impact Index Per Article: 9.2] [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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Mahmoud Pashazadeh A, Aghajani M, Nabipour I, Assadi M. An update on mobile phones interference with medical devices. RADIATION PROTECTION DOSIMETRY 2013; 156:401-406. [PMID: 23559585 DOI: 10.1093/rpd/nct091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Mobile phones' electromagnetic interference with medical devices is an important issue for the medical safety of patients who are using life-supporting medical devices. This review mainly focuses on mobile phones' interference with implanted medical devices and with medical equipment located in critical areas of hospitals. A close look at the findings reveals that mobile phones may adversely affect the functioning of medical devices, and the specific effect and the degree of interference depend on the applied technology and the separation distance. According to the studies' findings and the authors' recommendations, besides mitigating interference, using mobile phones at a reasonable distance from medical devices and developing technology standards can lead to their effective use in hospital communication systems.
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Affiliation(s)
- Ali Mahmoud Pashazadeh
- The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 3631, Iran
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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: 0.5] [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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