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Capareli F, Costa F, Tuszynski JA, Sousa MC, Setogute YDC, Lima PD, Carvalho L, Santos E, Gumz BP, Sabbaga J, de Castria TB, Jardim DL, Freitas D, Horvat N, Bezerra ROF, Testagrossa L, Costa T, Zanesco T, Iemma AF, Abou‐Alfa GK. Low-energy amplitude-modulated electromagnetic field exposure: Feasibility study in patients with hepatocellular carcinoma. Cancer Med 2023; 12:12402-12412. [PMID: 37184216 PMCID: PMC10278519 DOI: 10.1002/cam4.5944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/23/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Patients with advanced hepatocellular carcinoma (HCC) and poor liver function lack effective systemic therapies. Low-energy electromagnetic fields (EMFs) can influence cell biological processes via non-thermal effects and may represent a new treatment option. METHODS This single-site feasibility trial enrolled patients with advanced HCC, Child-Pugh A and B, Eastern Cooperative Oncology Group 0-2. Patients underwent 90-min amplitude-modulated EMF exposure procedures every 2-4 weeks, using the AutEMdev (Autem Therapeutics). Patients could also receive standard care. The primary endpoints were safety and the identification of hemodynamic variability patterns. Exploratory endpoints included health-related quality of life (HRQoL), overall survival (OS). and objective response rate (ORR) using RECIST v1.1. RESULTS Sixty-six patients with advanced HCC received 539 AutEMdev procedures (median follow-up, 30 months). No serious adverse events occurred during procedures. Self-limiting grade 1 somnolence occurred in 78.7% of patients. Hemodynamic variability during EMF exposure was associated with specific amplitude-modulation frequencies. HRQoL was maintained or improved among patients remaining on treatment. Median OS was 11.3 months (95% confidence interval [CI]: 6.0, 16.6) overall (16.0 months [95% CI: 4.4, 27.6] and 12.0 months [6.4, 17.6] for combination therapy and monotherapy, respectively). ORR was 24.3% (32% and 17% for combination therapy and monotherapy, respectively). CONCLUSION AutEMdev EMF exposure has an excellent safety profile in patients with advanced HCC. Hemodynamic alterations at personalized frequencies may represent a surrogate of anti-tumor efficacy. NCT01686412.
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Affiliation(s)
| | - Frederico Costa
- Oncology DepartmentHospital Sírio‐LibanêsSão PauloBrazil
- Autem Medical LLCHanoverNew HampshireUSA
| | - Jack A. Tuszynski
- Autem Medical LLCHanoverNew HampshireUSA
- Division of Experimental Oncology, Department of OncologyCross Cancer Institute, University of AlbertaEdmontonAlbertaCanada
| | | | | | - Pablo D. Lima
- Oncology DepartmentHospital Sírio‐LibanêsSão PauloBrazil
| | | | - Elizabeth Santos
- Oncology DepartmentHospital Sírio‐LibanêsSão PauloBrazil
- Oncology DepartmentA. C. Camargo Cancer CenterSão PauloBrazil
| | - Brenda P. Gumz
- Oncology DepartmentHospital Sírio‐LibanêsSão PauloBrazil
| | - Jorge Sabbaga
- Oncology DepartmentHospital Sírio‐LibanêsSão PauloBrazil
| | | | | | | | - Natally Horvat
- Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | | | | | - Tiago Costa
- Santa Casa de São Paulo School of Medical SciencesSão PauloBrazil
| | | | - Antonio F. Iemma
- Institute of Mathematics and Statistics, University of São PauloSão PauloBrazil
| | - Ghassan K. Abou‐Alfa
- Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Weill Medical College at Cornell UniversityNew YorkNew YorkUSA
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Mansourian M, Marateb H, Nouri R, Mansourian M. Effects of man-made electromagnetic fields on heart rate variability parameters of general public: a systematic review and meta-analysis of experimental studies. REVIEWS ON ENVIRONMENTAL HEALTH 2023:reveh-2022-0191. [PMID: 37195230 DOI: 10.1515/reveh-2022-0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/17/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVES The effects of man-made electromagnetic fields (EMFs) on the cardiovascular system have been investigated in many studies. In this regard, the cardiac autonomic nervous system (ANS) activity due to EMFs exposure, assessed by heart rate variability (HRV), was targeted in some studies. The studies investigating the relationship between EMFs and HRV have yielded conflicting results. We performed a systematic review and meta-analysis to assess the data's consistency and identify the association between EMFs and HRV measures. CONTENT Published literature from four electronic databases, including Web of Science, PubMed, Scopus, Embase, and Cochrane, were retrieved and screened. Initially, 1601 articles were retrieved. After the screening, 15 original studies were eligible to be included in the meta-analysis. The studies evaluated the association between EMFs and SDNN (standard deviation of NN intervals), SDANN (Standard deviation of the average NN intervals for each 5 min segment of a 24 h HRV recording), and PNN50 (percentage of successive RR intervals that differ by more than 50 ms). SUMMARY There was a decrease in SDNN (ES=-0.227 [-0.389, -0.065], p=0.006), SDANN (ES=-0.526 [-1.001, -0.05], p=0.03) and PNN50 (ES=-0.287 [-0.549, -0.024]). However, there was no significant difference in LF (ES=0.061 (-0.267, 0.39), p=0.714) and HF (ES=-0.134 (0.581, 0.312), p=0.556). In addition, a significant difference was not observed in LF/HF (ES=0.079 (-0.191, 0.348), p=0.566). OUTLOOK Our meta-analysis suggests that exposure to the environmental artificial EMFs could significantly correlate with SDNN, SDANN, and PNN50 indices. Therefore, lifestyle modification is essential in using the devices that emit EMs, such as cell phones, to decrease some signs and symptoms due to EMFs' effect on HRV.
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Affiliation(s)
- Mahsa Mansourian
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Marateb
- Biomedical Engineering Department, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Rasool Nouri
- Department of Medical Library and Information Sciences, School of Health Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Parizek D, Visnovcova N, Hamza Sladicekova K, Misek J, Jakus J, Jakusova J, Kohan M, Visnovcová Z, Ferencova N, Tonhajzerova I. Electromagnetic fields - do they pose a cardiovascular risk? Physiol Res 2023; 72:199-208. [PMID: 37159854 PMCID: PMC10226401 DOI: 10.33549/physiolres.934938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/20/2022] [Indexed: 01/23/2024] Open
Abstract
Mobile wireless communication technologies have now become an everyday part of our lives, 24 hours a day, 7 days a week. Monitoring the autonomous system under exposition to electromagnetic fields may play an important role in broading of our still limited knowledge on their effect on human body. Thus, we studied the interaction of the high frequency electromagnetic field (HF EMF) with living body and its effect on the autonomic control of heart rate using Heart Rate Variability (HRV) linear and nonlinear analyses in healthy volunteers. A group of young healthy probands (n=30, age mean: 24.2 ± 3.5 years) without any symptoms of disease was exposed to EMF with f=2400 MHz (Wi Fi), and f=2600 MHz (4G) for 5 minutes applied on the chest area. The short-term heart rate variability (HRV) metrics were used as an indicator of complex cardiac autonomic control. The evaluated HRV parameters: RR interval (ms), high frequency spectral power (HF-HRV in [ln(ms2)]) as an index of cardiovagal control, and a symbolic dynamic index of 0V %, indicating cardiac sympathetic activity. The cardiac-linked parasympathetic index HF-HRV was significantly reduced (p =0.036) and sympathetically mediated HRV index 0V % was significantly higher (p=0.002) during EMF exposure at 2400 MHz (Wi-Fi), compared to simulated 4G frequency 2600 MHz. No significant differences were found in the RR intervals. Our results revealed a shift in cardiac autonomic regulation towards sympathetic overactivity and parasympathetic underactivity indexed by HRV parameters during EMF exposure in young healthy persons. It seems that HF EMF exposure results in abnormal complex cardiac autonomic regulatory integrity which may be associated with higher risk of later cardiovascular complications already in healthy probands.
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Affiliation(s)
- D Parizek
- Department of Medical Biophysics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. ,
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Muacevic A, Adler JR, Verma M, Singh AK, John N, Jasrotia RB, Singh A. Association of Autonomic Balance With Phone Call Duration in Healthy Individuals. Cureus 2023; 15:e33566. [PMID: 36779133 PMCID: PMC9908824 DOI: 10.7759/cureus.33566] [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] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
Background This study aimed to estimate the association of autonomic balance with the duration of phone calls in healthy individuals. Methodology A total of 30 subjects aged between 18 and 30 years without any established systemic disease and using mobile phones for more than five years with minimum daily usage of 30 minutes were included in this analytical study. Heart rate variability (HRV) was recorded using a three-channel physiograph (AD Instruments South Asia (India) Pvt. Ltd., New Delhi, India) with the software LabChart PROV8.1.8 with HRV Module version 2.0.3 for 10 minutes. Time domain parameters were recorded in terms of the standard deviation of normal to normal interval (SDNN), root mean square of successive differences between normal heartbeats (RMSSD), R-R intervals greater than 50 ms (pRR50), and mean heart rate (MHR), and frequency domain parameters were total power, low-frequency power (LF), high-frequency power (HF), and the ratio of low-frequency to high-frequency power (LF/HF). HRV was recorded three times in each subject that included baseline HRV, HRV during the use of a mobile phone, and HRV after the use of a mobile phone. Results A total of 30 subjects (14 males and 16 females) participated in this study. The mean age of participants was 31.93 ± 8.59 years (32.07 ± 9.87 years for males, and 31.81 ± 7.64 years for females). There were no findings of significant arrhythmia in any of the participants. There was a significant difference in pRR50 on comparing all three phases (p = 0.036). However, there was no significant variation in other parameters such as very low frequency (VLF, ms2), VLF (%), LF (ms2), LF (%), HF (ms2), HF (%), LF/HF, SDNN (ms), RMSSD (ms), Poincare plot standard deviation perpendicular to the line of identity (ms), Poincare plot standard deviation along the line of identity (ms), systolic blood pressure (mmHg), and diabolic blood pressure (mmHg) during, before, and after exposure to mobile phone calls. There was no significant difference in the value of all parameters between males and females (p < 0.05). Conclusions Mobile phone calls may influence HRV and autonomic balance. This change may be affected by the electromagnetic field and by speaking as well.
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Amiri F, Moradinazar M, Moludi J, Pasdar Y, Najafi F, Shakiba E, Hamzeh B, Saber A. The association between self-reported mobile phone usage with blood pressure and heart rate: evidence from a cross-sectional study. BMC Public Health 2022; 22:2031. [PMID: 36344963 PMCID: PMC9639298 DOI: 10.1186/s12889-022-14458-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 10/26/2022] [Indexed: 11/09/2022] Open
Abstract
Background With the advancement of technology, the rate of access and use of mobile phones in different communities has increased significantly. Mobile phones emit electromagnetic waves and therefore excessive use of them may have harmful effects on physical and mental health and especially on the cardiovascular system. This study aimed to investigate the association between self-reported mobile phone use duration and blood pressure and heart rate (HR) using data from Ravansar non-communicable diseases (RaNCD) cohort study. Methods The present cross-sectional study was performed using the data of 8905 out of 10,065 participants in the RaNCD study in Iran. According to the mean self-reported duration of mobile phone usage (min/day) over the previous 12 months, all users were divided into four groups. The first and fourth groups had the least and most time using mobile phones respectively. The relationship between blood pressure and the duration of mobile phone use was determined using univariate and multiple linear regression. Results Of 8905 participants aged 35–65 years, 1515 (17.0%) of them didn't use mobile phones. The minimum, maximum, and mean duration of self-reported mobile phone use between users were 3.4, 50.4, and 19.5 min/day, respectively. A decrease in women's systolic and diastolic blood pressure (SBP and DBP) and HR was observed by increasing the duration of mobile phone use. With adjustment for effective confounding factors, there was a significant negative association between SBP [-2.52 (-4.11, -0.94)], DBP [-1.86 (-2.83, -0.89)], and duration of mobile use. Conclusion In this study, a significant decreasing trend was found between SBP, DBP, and HR and higher mobile phone usage in women. Based on regression analysis, SBP, DBP, and duration of mobile phone use were associated negatively in those who used their phones for at least 8 h.
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Affiliation(s)
- Fatemeh Amiri
- grid.412112.50000 0001 2012 5829Radiology and Nuclear Medicine Department, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- grid.412112.50000 0001 2012 5829Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jalal Moludi
- grid.412112.50000 0001 2012 5829Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- grid.412112.50000 0001 2012 5829Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebrahim Shakiba
- grid.412112.50000 0001 2012 5829Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Saber
- grid.412112.50000 0001 2012 5829Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Schneider R. Mobile phone induced EMF stress is reversed upon the use of protective devices: results from two experiments testing different boundary conditions. Electromagn Biol Med 2022; 41:429-438. [PMID: 36189775 DOI: 10.1080/15368378.2022.2129380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This work examines (a) the impact of electromagnetic fields (EMF) on heart rate variability (HRV), saliva cortisol, arterial blood oxygenation, and tympanic temperature, and (b) the potential effect of protective devices developed to counter EMF-induced stress. In a pilot study, recordings were taken during a 15-min mobile phone call emitting a high burden of EMF (electric, magnetic, high frequency) after a baseline measurement at rest with very low EMF. In a second visit, this was repeated with participants using three protective devices (insoles, pendant, mobile phone chip). In the main study, four experimental arms were employed, two of which replicated the experimental setup of the pilot study, and two of which examined the effect of only one mobile phone chip in an open-hidden-paradigm. In both experiments, exposure to EMF decreased HRV and increased salivary cortisol. In the protective experimental condition, HRV increased above and cortisol decreased below the level of the baseline measures. All differences were large and specific and not modulated by non-specific effects like placebo effects.
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The Preliminary Chronic Effects of Electromagnetic Radiation from Mobile Phones on Heart Rate Variability, Cardiac Function, Blood Profiles, and Semen Quality in Healthy Dogs. Vet Sci 2022; 9:vetsci9050201. [PMID: 35622729 PMCID: PMC9147188 DOI: 10.3390/vetsci9050201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 12/04/2022] Open
Abstract
The present study aims to determine the effects of long-term exposure to electromagnetic radiation from mobile phones (MPs) on heart rate variability (HRV), cardiac function, blood profiles, body surface temperature, and semen quality in healthy dogs. Eight male dogs were exposed to MPs (1962–1966 MHz; specific absorption rate 0.96 W/kg) for 2 h/day, 5 days/week, for 10 weeks. Holter monitoring for HRV analysis was performed at baseline (BL) and every 2 weeks, until the end of the study. Electrocardiograms (ECG), blood pressure (BP), echocardiography, cardiac troponin I (cTnI), hematology and biochemistry profiles, body surface temperature, and semen quality were evaluated at BL, week 5, and week 10 during exposure. The results showed that most of the HRV parameters did not significantly differ among timepoints, except for the mean of an interval between continuous normal R waves in week 6 that was higher than that at BL (p = 0.022). The RR and QT intervals from ECG in week 5 were prolonged, compared to the BL values (p = 0.001 and p = 0.003, respectively), but those parameters were within the normal limits. The echocardiography, BP, cTnI concentrations, body surface temperature, and semen quality results were not different from BL values. In conclusion, this study found no evidence suggesting an adverse effect of cell phone exposure on HRV, cardiac function, blood profiles, body surface temperature, or semen quality in healthy dogs, when exposed for 10 weeks.
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Kosharnyi VV, Nefodova OO, Abdul-Ogly LV, Rutgaizer VG, Kramar SB, Kuznetsova OV, Velikorodny VI. CHARACTERISTIC MACRO- AND MICROSCOPIC CHANGES OF MYOCARDIA UNDER THE INFLUENCE OF MICROWAVE ELECTROMAGNETIC RADIATION UNDER CONDITIONS OF HYPOTHYROID STATE. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-3-166-389-393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lai YF, Wang HY, Peng RY. Establishment of injury models in studies of biological effects induced by microwave radiation. Mil Med Res 2021; 8:12. [PMID: 33597038 PMCID: PMC7890848 DOI: 10.1186/s40779-021-00303-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 01/29/2021] [Indexed: 02/08/2023] Open
Abstract
Microwave radiation has been widely used in various fields, such as communication, industry, medical treatment, and military applications. Microwave radiation may cause injuries to both the structures and functions of various organs, such as the brain, heart, reproductive organs, and endocrine organs, which endanger human health. Therefore, it is both theoretically and clinically important to conduct studies on the biological effects induced by microwave radiation. The successful establishment of injury models is of great importance to the reliability and reproducibility of these studies. In this article, we review the microwave exposure conditions, subjects used to establish injury models, the methods used for the assessment of the injuries, and the indicators implemented to evaluate the success of injury model establishment in studies on biological effects induced by microwave radiation.
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Affiliation(s)
- Yun-Fei Lai
- Beijing Institute of Radiation Medicine, Beijing, 100850, China
| | - Hao-Yu Wang
- Beijing Institute of Radiation Medicine, Beijing, 100850, China.
| | - Rui-Yun Peng
- Beijing Institute of Radiation Medicine, Beijing, 100850, China.
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AYDIN F, AKŞİT E, HÜSEYİNOĞLU AYDIN A, TURGAY YILDIRIM Ö. The Effects of Heart-to-Mobile Phone Distance on the Circulatory System. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.835364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Moradinazar M, Pasdar Y, Najafi F, Shakiba ,E, Hamzeh B, Moludi J, Amiri F. The effect of duration of mobile phone usage on blood pressure and heart rate: Evidence from a cohort study (Preprint). J Med Internet Res 2020. [DOI: 10.2196/21427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Béres S, Németh Á, Ajtay Z, Kiss I, Németh B, Hejjel L. Cellular Phone Irradiation of the Head Affects Heart Rate Variability Depending on Inspiration/Expiration Ratio. In Vivo 2018; 32:1145-1153. [PMID: 30150437 DOI: 10.21873/invivo.11357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/27/2018] [Accepted: 05/29/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Mobile phones may have harmful health effects and clinical examinations report ambiguous results of exposure concerning neurophysiological and cardiovascular actions. MATERIALS AND METHODS This study investigated heart rate asymmetry (HRA) and heart rate variability (HRV) parameters with 1:2 and 1:1 metronome-paced inspiration/expiration ratios during short-term 1,800MHz GSM cellular phone exposure in 20 healthy volunteers. RESULTS Significant HRA changes by Porta and Guzik indices were not found on exposure compared to sham exposure. Time-domain HRV parameters on exposure showed significant differences at 1:1 paced, but not at 1:2 paced breathing compared to sham exposure. A mild post-exposure effect was observed regarding root mean square of successive RR-differences. CONCLUSION The findings reflect persisting acute effects of GSM handset emission on the autonomic nervous system. Exploring its influences on health status and survival needs further studies. Symmetrical breathing can be used as a sensitizing factor in other HRV/HRA analysis studies.
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Affiliation(s)
| | - Ádám Németh
- Heart Institute, University of Pécs, Pécs, Hungary
| | - Zénó Ajtay
- Heart Institute, University of Pécs, Pécs, Hungary
| | - István Kiss
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Balázs Németh
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
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Electromagnetic interference of mobile phones: insight into heart rate variability. Anatol J Cardiol 2017; 17:248. [PMID: 28321097 PMCID: PMC5864987 DOI: 10.14744/anatoljcardiol.2017.7617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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