title: Interference with cardiac pacemakers by cellular telephones.
abstract: BACKGROUND
  A growing body of evidence suggests that electromagnetic interference may occur between cardiac pacemakers and wireless hand-held (cellular) telephones, posing a potential public health problem. Electromagnetic interference may occur when the pacemaker is exposed to an electromagnetic field generated by the cellular telephone.
  
  
  METHODS
  In this multicenter, prospective, crossover study, we tested 980 patients with cardiac pacemakers with five types of telephones (one analogue and four digital) to assess the potential for interference. Telephones were tested in a test mode and were programmed to transmit at the maximal power, simulating the worst-case scenario; in addition, one telephone was tested during actual transmission to simulate actual use. Patients were electrocardiographically monitored while the telephones were tested at the ipsilateral ear and in a series of maneuvers directly over the pacemaker. Interference was classified according to the type and clinical significance of the effect.
  
  
  RESULTS
  The incidence of any type of interference was 20 percent in the 5533 tests, and the incidence of symptoms was 7.2 percent. The incidence of clinically significant interference was 6.6 percent. There was no clinically significant interference when the telephone was placed in the normal position over the ear. Interference that was definitely clinically significant occurred in only 1.7 percent of tests, and only when the telephone was held over the pacemaker. Interference was more frequent with dual-chamber pacemakers (25.3 percent) than with single-chamber pacemakers (6.8 percent, P<0.001) and more frequent with pacemakers 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 function of implanted cardiac pacemakers. However, when telephones are placed over the ear, the normal position, this interference does not pose a health risk.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Hayes
authors.forename: P J
authors.initials: PJ
authors.lastname: Wang
authors.forename: D W
authors.initials: DW
authors.lastname: Reynolds
authors.forename: M
authors.initials: M
authors.lastname: Estes
authors.forename: J L
authors.initials: JL
authors.lastname: Griffith
authors.forename: R A
authors.initials: RA
authors.lastname: Steffens
authors.forename: G L
authors.initials: GL
authors.lastname: Carlo
authors.forename: G K
authors.initials: GK
authors.lastname: Findlay
authors.forename: C M
authors.initials: CM
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D018592:Cross-Over Studies; D004244:Dizziness / Q000209:etiology; D004562:Electrocardiography; D004574:Electromagnetic Fields / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D013689:Telephone