Safety of smartwatches and their chargers in patients with cardiac implantable electronic devices

Abstract

Aims Cardiac implantable electronic devices (CIEDs) are susceptible to electromagnetic interference (EMI). Smartwatches and their chargers could be a possible source of EMI. We sought to assess whether the latest generation smartwatches and their chargers interfere with proper CIED function. Methods and results We included consecutive CIED recipients in two centres. We tested two latest generation smartwatches (Apple Watch and Samsung Galaxy Watch) and their charging cables for potential EMI. The testing was performed under continuous electrocardiogram recording and real-time device telemetry, with nominal and ‘worst-case’ settings. In vitro magnetic field measurements were performed to assess the emissions from the tested devices, initially in contact with the probe and then at a distance of 10 cm and 20 cm. In total, 171 patients with CIEDs (71.3% pacemakers–28.7% implantable cardioverter-defibrillators) from five manufacturers were enrolled (63.2% males, 74.8 ± 11.4 years), resulting in 684 EMI tests. No EMI was identified in any patient either under nominal or ‘worst-case scenario’ programming. The peak magnetic flux density emitted by the smartwatches was similar to the background noise level (0.81 μT) even when in contact with the measuring probe. The respective values for the chargers were 4.696 μΤ and 4.299 μΤ for the Samsung and Apple chargers, respectively, which fell at the background noise level when placed at 20 cm and 10 cm, respectively. Conclusion Two latest generation smartwatches and their chargers resulted in no EMI in CIED recipients. The absence of EMI in conjunction with the extremely low intensity of magnetic fields emitted by these devices support the safety of their use by CIED patients.

Interference by Modern Smartphones and Accessories with Cardiac Pacemakers and Defibrillators

“…In a study testing the Apple Watch Series 3 and Samsung Galaxy Watch, a total of 684 EMI tests were carried out on 171 patients with CIEDs from five manufacturers. There were no cases of EMI under nominal or worst-case scenario programming [34]. These studies differ from the 2021 published case report where a patient presented with a complaint of ICD beeping at night.…”

Smartwatches in healthcare medicine: assistance and monitoring; a scoping review

“…The emission levels of the tested smartwatches and their magnetic chargers were evaluated by measuring low-frequency magnetic fields between 110 and 400 kHz. Each smartwatch was activated and measured separately, first directly in contact with the probe, then at a distance of 10 cm and 20 cm [ 62 ].…”

The Use of Electrocardiogram Smartwatches in Patients with Cardiac Implantable Electrical Devices

“…A study by Lacour et al evaluated the incidence and consequences of electromagnetic interference produced by a smartwatch in patients with transvenous CIEDs and reported no evidence of device–device interaction [ 12 ]. Tzeis et al performed 684 EMI tests in 171 CIED patients (71% pacemakers, 29% ICDs) using two smartwatch models [ 13 ]. Despite testing in the “worst-case” conditions with placement of the wearable directly above the implanted devices, the smartwatches did not cause any EMI in either study, neither with the implanted device nor the interrogation telemetry.…”

“…Smartwatches have also been shown to be safer compared with other portable electronic devices such as electronic pens or in-ear headphones regarding the CIED interaction [ 14 ]. The very low energy emission by the smartwatches and the peak magnetic flux density emitted by the smartwatches, which was similar to the background noise level (0.81 μT), coupled with the technological advances in CIED platforms to filter and process the signals, explain this negligible to no risk of EMI [ 13 ]. More recently, a benchmark study evaluated electrical interference of bioimpedance technology available in selected smartwatches on CIEDs following the FDA’s accepted ISO 14177 standard [ 15 ].…”