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Electromagnetic Interferences With CIEDs
Quick Takes
- The overall incidence of electromagnetic interferences (EMIs) between the iPhone 6 and cardiovascular implantable electronic devices (CIEDs) was very low.
- Of note, the Apple Watch did not cause any EMIs with CIEDs, while the iPhone 6 frequently caused interferences with interrogation telemetry.
- Individualized testing of patients for EMIs between their personal cell phone and wearable and their CIED would be ideal.
Study Questions:
What is the incidence and consequence of contemporary mobile phone and smartwatch-produced electromagnetic interferences (EMIs)?
Methods:
The investigators subjected 148 patients with cardiovascular implantable electronic devices (CIEDs) and leads from four different manufacturers to 1,352 tests. Analyzed CIEDs included 51 pacemakers, five cardiac resynchronization therapy (CRT) pacemakers, 46 implantable cardioverter-defibrillators, 43 CRT therapy defibrillators, and three implantable loop recorders. To analyze a possible influence of certain distances between the mobile phone (iPhone 6) and the smartwatch (Apple Watch A1553) to the CIED, both were placed either directly above implanted devices or at the right wrist. All possible activations of the iPhone and the Apple Watch, including the standby, dialing, and connecting modes (telephone connection and Internet access) were tested. In addition, the authors studied incidence and characteristics of interferences with interrogation telemetry. EMIs with the CIED were defined as any change in cardiac rhythm seen on the surface electrocardiogram with or without clinical symptoms such as palpitations, dizziness, syncope, or discomfort.
Results:
In this study, only a single case of mobile phone–induced EMI on a dual-chamber pacemaker was observed. Utilizing wanded telemetry, iPhone-induced interferences were found in 14% of the patients. In all cases, interferences with the CIED programmer only occurred when the iPhone was placed directly over the CIED in dialing or connecting mode, whereas no interferences were observed with the Apple Watch.
Conclusions:
The authors concluded that risk of EMIs of the iPhone 6 and the Apple Watch with CIEDs is low.
Perspective:
This study reports that the incidence of EMIs between the iPhone 6 and CIEDs was very low. Of note, the Apple Watch did not cause any EMIs with CIEDs, while the iPhone 6 frequently caused interferences with interrogation telemetry. However, neither the iPhone 6 nor the Apple Watch caused a magnet effect when placed directly over the CIED. The swift evolution of CIEDs and mobile phone and wearable technology makes it imperative to regularly re-evaluate safety recommendations for patients with CIEDs, with individualized testing of patients for EMIs between their personal cell phone and wearable and their CIED ideally.
Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias
Keywords: Arrhythmias, Cardiac, Cardiac Resynchronization Therapy, Cardiac Resynchronization Therapy Devices, Cell Phone, Defibrillators, Implantable, Dizziness, Electrocardiography, Pacemaker, Artificial, Secondary Prevention, Syncope, Telemetry, Vertigo
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