14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-182

Electromagnetic interference with pacemakers and implantable cardioverter defibrillators

Maurizio Santomauro, Angelo Costanzo, Luca Ottaviano, Raffaele Cresta, Massimo Chiariello.
Department of cardiology and cardiac surgery, University Federico II, Naples, Italy

Introduction

Non-ionizing radiation is emitted by a different types of equipment such as microwave ovens, hight-voltage electrical lines, cellular phones, etc. This kind of radiation can cause interference. Many electronic medical devices such as pacemakers (PM) and implantable cardioverter defibrillators (ICD) can malfunction as a consequence of electromagnetic interference (EMI)^1-7. EMI is spread by different modes such as electrical lines or cables, electrostatic induction, electromagnetic radiation, intentional transmitters (radar, radio, TV and satellite transmissions, mobile telecommunication systems, scientific equipment), unintentional transmitters (induction heaters, electrical equipment, car ignition systems, diathermy generators). The frequency at which the electric field oscillates is important – the same field strenght can have more severe effects towards the lower and higher of the frequency range used for radio transmission (Tab. I).

TABLE I

When an electronic medical device is exposed to radiofrequency (RF) signals, RF energy is absorbed by the electronic circuitry and other components, and functioning may be altered.

Today, PM and ICD patients are exposed to a myriad of new sources of electromagnetic fields: at home, work, and other everyday environments. Cellular phones have become the most recent concern^8-13. PM and ICD are made up of electronic circuits which can be affected by electromagnetic fields in a negative way; even if presently, these devices are protected from most of electromagnetic sources.

The effects of EMI on PM and ICD are based on several physical factors such as the strenght of external signal, the distance between the signal and the PM and ICD, the frequency range, modulation type and immunity leve l of the PM and ICD. The outcome of the effect of EMI on the PM and ICD can be pacing inhibition by triggering of a ventricular pacing rhythm that is more rapid with VDD and DDD PM, or asynchronous pacing, or other pacing modes^14-16.

Our study has evaluated the possible negative effects of environmental electromagnetic radiation on PM and ICD, which increase the possible health risk for patients due to PM and ICD malfunction.