Interference with Cardiac Pacemakers by Cellular Telephones
David L. Hayes, M.D., Paul J. Wang, M.D., Dwight W. Reynolds, M.D., N.A. Mark Estes, M.D., John L. Griffith, Ph.D., Rebecca A. Steffens, M.P.H., George L. Carlo, Ph.D., Gretchen K. Findlay, B.S., and Claudine M. Johnson, M.A.
Background A growing body of evidence suggests that electromagneticinterference may occur between cardiac pacemakers and wirelesshand-held (cellular) telephones, posing a potential public healthproblem. Electromagnetic interference may occur when the pacemakeris exposed to an electromagnetic field generated by the cellulartelephone.
Methods In this multicenter, prospective, crossover study, wetested 980 patients with cardiac pacemakers with five typesof telephones (one analogue and four digital) to assess thepotential for interference. Telephones were tested in a testmode and were programmed to transmit at the maximal power, simulatingthe worst-case scenario; in addition, one telephone was testedduring actual transmission to simulate actual use. Patientswere electrocardiographically monitored while the telephoneswere tested at the ipsilateral ear and in a series of maneuversdirectly over the pacemaker. Interference was classified accordingto the type and clinical significance of the effect.
Results The incidence of any type of interference was 20 percentin the 5533 tests, and the incidence of symptoms was 7.2 percent.The incidence of clinically significant interference was 6.6percent. There was no clinically significant interference whenthe telephone was placed in the normal position over the ear.Interference that was definitely clinically significant occurredin only 1.7 percent of tests, and only when the telephone washeld over the pacemaker. Interference was more frequent withdual-chamber pacemakers (25.3 percent) than with single-chamberpacemakers (6.8 percent, P < 0.001) and more frequent withpacemakers without feed-through filters (28.9 to 55.8 percent)than with those with such filters (0.4 to 0.8 percent, P = 0.01).
Conclusions Cellular telephones can interfere with the functionof implanted cardiac pacemakers. However, when telephones areplaced over the ear, the normal position, this interferencedoes not pose a health risk.
Source Information
From the Mayo Clinic, Rochester, Minn. (D.L.H.); New England Medical Center, Boston (P.J.W., N.A.M.E., J.L.G.); University of Oklahoma Health Sciences Center, Oklahoma City (D.W.R.); and Health and Environmental Sciences Group, Ltd., Washington, D.C. (R.A.S., G.L.C., G.K.F., C.M.J.).
Address reprint requests to Dr. Hayes at the Mayo Clinic, Department of Cardiology, 200 First St., SW, East 16, Rochester, MN, 55905.
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