Electromagnetic Interference and Implanted Cardiac Devices: The Nonmedical Environment (Part I)

Abstract

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. Device Responses to Electromagnetic Interference Before discussing EMI from specific sources, it is important to emphasize that the clinical consequences of the interaction will depend on the type of interaction, type of device, and patient characteristics (Table 2). All

Correlation of Geomagnetic Activity With Implantable Cardioverter Defibrillator Shocks and Antitachycardia Pacing

“…It is well known that electromagnetic interference can pose a danger to patients with an ICD; 15,16 ventricular oversensing with subsequent delivery of inappropriate therapies, temporary or definitive suspension of all antitachycardia therapies or hardware damage can pose as possible mechanisms. 17–19 In other situations the use of magnets is desirable, for example when an ICD needs to be voluntarily inhibited from delivering therapies in surgical patients when tools that can interefere with the ICD are used.…”

Cardiac Implantable Electronic Device Safety during Magnetic Resonance Imaging

“…We defined contraindication for an MRI based on previous reports 6)7)8). This group in our current study included patients with (1) an abandoned lead, (2) epicardially located leads, (3) a scanning area in proximity to the device (such as thorax area), (4) devices implanted within the previous 6 weeks, or (5) individuals who were subjected to an MRI field strength >1.5 Tesla.…”

“…Although MRI-conditional CIEDs are now widely available2)3)4)5) patients with non-MRI conditional devices and specific contraindications may require an MRI examination. The aim of this study was to evaluate the safety of conducting an MRI on patients with CIEDs in variable conditions, including cases with a previously known contraindication for this procedure 6)7)8)…”

Interferenz: elektromagnetische Felder und Schrittmacher oder implantierte Defibrillatoren

“…B. Oversensing, Undersensing, Reed-Schalter-Aktivierung), vom Geräte-Typ (SM oder ICD) und vom Eigenrhythmus der Patienten ab [2]. Bei Schrittmachern kann eine EMI zur inadäquaten Stimulationsunterdrückung und konsekutiv zu Bradykardie oder Asystolie führen.…”