Implantable Cardioverter Defibrillators and Cellular Telephones: Is There Any Interference?

Abstract

The aim of our study was to consider cellular telephone interference using different cellular telephones and implantable cardioverter defibrillator (ICD) models. Thirty (26 men, 4 women) patients with ICDs were considered during follow-up. The ICD models were: Telectronics (7), CPI (7), Medtronic (7), Ventritex (5), and Ela Medical (4). All patients were monitored with surface ECG; permanent telemetric endo-ECG monitoring was activated. Then, the effect of two different European telephone systems were tested: TACS system (Sony CM-R111, 2W power) and GSM system (Motorola MG1-4A11, 2 W power). For both systems, the effect during call, reception, active conversation (dialogue), and passive conversation (listening) were observed. Cellular telephones were located first in contact with the programming head, then near the leads system, and lastly, in the hands of the patient. At the end of the evaluations, memories were interrogated again to check for false arrhythmia detections. In five of these patients during arrhythmia induction at device implant (first implant or ICD replacement), we also evaluated possible interference between cellular telephones in the reception phase and the ventricular fibrillation detection phase of the ICD. All evaluated models showed significant noise in the telemetric transmission when the cellular telephone (both TACS and GSM) was located near the ICD and the programming head; noise was particularly significant during call and reception, in most cases leading to loss of telemetry. No false arrhythmia detections have been observed during tests with cellular telephones located on the ICDs. During tests performed with cellular telephones located near the leads or in the hands of patients, no telemetric noises orfalse arrhythmia detections were observed. During induced ventricularfibrillation and cellular telephones in reception mode near the device, the arrhythmia recognition was always correct and not delayed. In conclusion, present ICD models seem to be well protected from electromagnetic interference caused by European cellular telephones (TACS and GSM), without under-/oversensing of ventricular arrhythmias. However, cellular telephones disturb telemetry when located near the programming head. ICD patients should not be advised against the use of cellular telephones, but it has to be avoided during ICD interrogation and programming.

Effects of External Electrical and Magnetic Fields on Pacemakers and Defibrillators

“…22 Studies of modern cellular phones and CIEDs with routine use of dedicated feedthrough filters have noted minimal or no EMI. 23, 26 In the setting of ICDs, only transient telemtery loss, 24 without clinically significant EMI has been reported. 20, 21, 25 Current recommendations indicate holding cellular phones to the ear contralateral to the CIEDs, avoiding close contact between the CIEDs and the phone, and avoiding the use of cellular phones during programming of CIEDs.…”

A Literature Review of Transmission Effectiveness and Electromagnetic Compatibility in Home Telemedicine Environments to Evaluate Safety and Security

“…Barbaro et al 34 concluded that although in vitro studies under worst-case conditions demonstrate the potential of GSM cellular telephones to interfere with ICDs, generating false detection, inhibition, or reprogramming, no such serious interference was found in vivo or under realistic conditions in vitro. Occhetta et al, 35 Chiladakis et al, 36 and Tandogan et al 37 had observed no evidence of serious interferences in the functionality of the implanted defibrillator. Table 5 details other interferences in PMs and defibrillators found in papers that refer also to interferences in different medical instruments with wireless networks.…”

Patient Safety and Electromagnetic Protection: A Review

“…In 1999, two articles, Barbaro et al (1999) and Occhetta et al (1999), evaluated interferences between implantable cardioverter defibrillators (ICD) and Total Access Communication System (TACS) and GSM technologies. In Barbaro et al (1999), in vitro tests were performed with six ICDs and three phones (two GSM and one TACS) and in vivo tests with 13 patients and eight different models of ICDs with the maximum emission power at different stages of communication.…”

“…Effects were circumscribed to the area closely surrounding the connectors. Occhetta et al (1999) performed a study on 30 patients, placing the mobile phone at different positions in several phases: call, call receiving, conversation, talking, and listening. Two different European telephone systems were tested: TACS system (Sony CM-RIII, 2 W power) and GSM system (Motorola MGI ϳ 4A11, 2 W power).…”