EP Lab Digest - May 2008 - (Page 59)

MAY 2008 EP RESEARCH 59 Can Digital Music Players Cause Interference with Implantable Devices? Interview with Dr. Charles Berul Interview by Jodie Elrod pacemaker/ICD and just display “electrical noise.” Once the music player was removed a few inches, the interference with the programmer resolved. Patients typically schedule device interrogations only about 1-3 times per year. They may bring an iPod to testing, but would never have it on top of the pacer during testing, so it is not an issue. you be doing any further research? Do you think further research in this area is needed? I think our results should be reassuring, but there is a small possibility that we did not observe interference because it is an infrequent event and we had relatively small numbers. The next steps will be to assess longer term interactions. Also, twenty-six patients (53%) who experienced interference with telemetry programmer communication used the same manufacturer’s device. Is this higher incidence statistically significant? I don’t think this is a significant difference by manufacturer. It is too small a number to be sure. Should larger DMPs (30 GB) be avoided by ICD and pacemaker patients? No.They just shouldn’t be placed right on top of the pacemaker, and should not be used within inches of the device during programming or interrogation sessions. an digital music players (DMPs) such as iPods cause interference with implantable devices such as pacemakers and ICDs? In their research, Charles Berul, MD and colleagues recently found that DMPs can interfere with programmer communication, but not in a way that affected device function.1 Read more about their recent research here. Dr. Berul is a Senior Associate in Cardiology at Children’s Hospital and Associate Professor of Pediatrics at Harvard Medical School in Boston. C How do your findings compare with other DMP-related research? How do you explain any difference in findings? Could patient age range be a possible factor? Thaker and colleagues2 have a new article in the same issue of HeartRhythm, and there is an accompanying editorial by Dr. Krahn.3 In their research they studied much older adults, and now state that there is not any interference with pacing, but did report interference with sensing and the programmer (like ours).They also found that all interference goes away if removed a few inches. The editorial shed some doubt on the Thaker results, but we did not disprove them. Will remote monitoring be a possible future safety concern for ICD and pacemaker patients who use DMPs? No, this will not be an issue. For patients using remote monitoring, we advise that they not put the DMP right on top of the pacemaker or use it within inches of the device during the remote interrogation sessions. What made you decide to do this research? Why was it important to re-evaluate previous findings? We were somewhat skeptical about the preliminary report presented at Heart Rhythm last May. It received a lot of media coverage, but didn’t have a lot of scientific data. As a large children’s hospital, we see many young patients with pacemakers/ICDs who use iPods and other digital music players, and had not observed any problems. Therefore, we wanted to properly design a study to test this hypothesis. How might programmer interference compromise device interrogation? How often do pacemaker and ICD patients generally need to schedule device interrogation, and in your experience, have these patients brought their DMPs with them to appointments? It would sometimes disrupt communication between the programmer and References Do your findings rule out the possibility of DMP interference? Will 1. Webster G, Jordao L, Martuscello M, et al. Digital music players cause interference with interrogation telemetry for pacemakers and implantable cardioverter-defibrillators without affecting device function. Heart Rhythm 2008;5:545–550. 2. Thaker JP, Patel MB, Jongnarangsin K, et al. Electromagnetic interference with pacemakers caused by portable media players. Heart Rhythm 2008;5:538-544. 3. Krahn AD, Yee R. Pacemakers and Portable Media Players: Harm or harmony? Heart Rhythm 2008;5:551-552. Describe your study methods. In addition, how long was each individual patient studied? We prospectively enrolled patients as they came in for their routine clinic visits, and ultimately tested four different models against different pacemaker/ICD brands. A total of 51 patients were enrolled, including both children and adults. Their average age was 22 years (age range 6-60). The music players tested were the iPod Nano, iPod Video, Microsoft Zune, and Sandisk Sansa. Each was tested for a few minutes at a time, and not over days. What did your results show? We found no effect of music players on pacemakers or ICDs. There was frequent interference with the programmers (41%), but this never affected pacing. http://www.epcatheters.com http://www.epcatheters.com

Table of Contents Feed for the Digital Edition of EP Lab Digest - May 2008

EP Lab Digest - May 2008 Is There an Under-Referral of Women for Atrial Fibrillation Ablation? A Hybrid Approach to the Cure of Atrial Fibrillation Contents Letter from the Editor Spotlight Interview: University of Michigan Health System 10-Minute Interview: Amit J. Shanker, MD Modular EP Units: Are They Possible? One Hospital’s Experience All About My Job: Technician Supervisor (New Column!) Alcohol Septal Ablation in the Cath Lab: What is it All About? About the Canadian Heart Rhythm Society: Interview with Martin J. Gardner, MD, FRCP(C), FACC Email Discussion Group: May 2008 Second Annual Salary Survey My First Year in Electrophysiology: What Have I Got Myself Into? Highlight on Technology: Video-Audio Integration for the EP Lab On the Horizon: A New Remote Catheter Manipulation System Striving for Excellence in the Care of Cardiac Patients Five Reasons to Participate with a Professional Organization Suspected Shunting of Defibrillation Energy in the EP Lab Can Digital Music Players Cause Interference with Implantable Devices? ECG 101: Ambulatory ECG Monitoring Events Calendar Industry News and Products Classifieds Advertisers Index

EP Lab Digest - May 2008

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