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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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Lennerz C, Schaarschmidt C, Blažek P, Knoll K, Kottmaier M, Reents T, Bourier F, Lengauer S, Popa M, Wimbauer K, Bahlke F, Krafft H, Englert F, Friedrich L, Schunkert H, Hessling G, Deisenhofer I, Kolb C, O'Connor M. High-power chargers for electric vehicles: are they safe for patients with pacemakers and defibrillators? Europace 2023; 25:euad042. [PMID: 37067822 PMCID: PMC10227864 DOI: 10.1093/europace/euad042] [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: 11/18/2022] [Accepted: 01/25/2023] [Indexed: 04/18/2023] Open
Abstract
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.
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Affiliation(s)
- Carsten Lennerz
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
- DZHK (German Centre for Cardiovascular Research) partner site Munich Heart Alliance, Pettenkoferstr. 8a & 9, 80336 Munich, Germany
| | - Claudia Schaarschmidt
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Patrick Blažek
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Katharina Knoll
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
- DZHK (German Centre for Cardiovascular Research) partner site Munich Heart Alliance, Pettenkoferstr. 8a & 9, 80336 Munich, Germany
| | - Marc Kottmaier
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
- DZHK (German Centre for Cardiovascular Research) partner site Munich Heart Alliance, Pettenkoferstr. 8a & 9, 80336 Munich, Germany
| | - Tilko Reents
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Felix Bourier
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Sarah Lengauer
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Miruna Popa
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Katharina Wimbauer
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Fabian Bahlke
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Hannah Krafft
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Florian Englert
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Lena Friedrich
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Heribert Schunkert
- DZHK (German Centre for Cardiovascular Research) partner site Munich Heart Alliance, Pettenkoferstr. 8a & 9, 80336 Munich, Germany
- German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Gabriele Hessling
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Isabel Deisenhofer
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Christof Kolb
- German Heart Centre Munich, Department of Electrophysiology, Technical University of Munich, Lazarettstr. 36, 80636 Munich, Germany
| | - Matthew O'Connor
- Cardiology Department, Auckland City Hospital, 2 Park Road, Grafton, 1023 Auckland, New Zealand
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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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Sławiński G, Sławińska M, Usarek Z, Sobjanek M, Kempa M, Liżewska-Springer A, Lewicka E, Nowicki RJ, Raczak G. Electromagnetic Field Associated With Dermoscope Magnets May Affect the Safety of Cardiac Implanted Electronic Devices Patients. Front Cardiovasc Med 2021; 8:757032. [PMID: 34722685 PMCID: PMC8551606 DOI: 10.3389/fcvm.2021.757032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/17/2021] [Indexed: 12/02/2022] Open
Abstract
Dermoscopy is currently used as an auxiliary tool in general dermatology. Since some commercially available dermoscopes have built-in magnets, electromagnetic interference (EMI) may occur when examining cardiac implantable electronic devices (CIED) patients. The aim of the study was to create maps of electromagnetic fields defining a safe distance in terms of EMI. The study was performed in laboratory conditions using measuring equipment specially designed for this purpose. The following dermoscopes have been tested: Illuco IDS-1100, Visiomed Luminis, Visiomed Luminis 2, Heine NC2 with and without a contact plate, DermLite DL4, and DermLite Handyscope. Measurements were made for the following set of lift-off distances: 5, 10, 20, 30, 40, 50, and 150 mm. Each 2D scan consisted of 10-line scans shifted from each other by 10 mm. The strength of the magnetic field decreased with the distance from the faceplate. The distribution of the magnetic field differed depending on the position of the magnets. The highest magnetic field was recorded in the center of the Heine NC2 faceplate (up to 8 mT). In most cases, at a distance of 10 mm, the magnetic field strength was measured below 1 mT, with the exception of Heine NC2 and Heine NC2 with a contact plate. All tested dermoscopes generated a magnetic field of <1 mT at the distance of 20 mm. The use of dermoscopes with built-in magnets may affect the functioning of CIEDs, and the impact may vary depending on the type of dermoscope.
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Affiliation(s)
- Grzegorz Sławiński
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Zbigniew Usarek
- Institute of Nanotechnology and Materials Science, Faculty of Applied Physics and Mathematics, Gdańsk University of Technology, Gdańsk, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Maciej Kempa
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Grzegorz Raczak
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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