title: Electromagnetic interference with cardiac pacemakers and implantable cardioverter-defibrillators from low-frequency electromagnetic fields in vivo.
abstract: OBJECTIVE
  Electromagnetic interference (EMI) can pose a danger to workers with pacemakers and implantable cardioverter-defibrillators (ICDs). At some workplaces electromagnetic fields are high enough to potentially inflict EMI. The purpose of this in vivo study was to evaluate the susceptibility of pacemakers and ICDs to external electromagnetic fields.
  
  
  RESULTS
  Eleven volunteers with a pacemaker and 13 with an ICD were exposed to sine, pulse, ramp, and square waveform magnetic fields with frequencies of 2-200 Hz using Helmholtz coil. The magnetic field flux densities varied to 300 µT. We also tested the occurrence of EMI from an electronic article surveillance (EAS) gate, an induction cooktop, and a metal inert gas (MIG) welding machine. All pacemakers were tested with bipolar settings and three of them also with unipolar sensing configurations. None of the bipolar pacemakers or ICDs tested experienced interference in any of the exposure situations. The three pacemakers with unipolar settings were affected by the highest fields of the Helmholtz coil, and one of them also by the EAS gate and the welding cable. The induction cooktop did not interfere with any of the unipolarly programmed pacemakers.
  
  
  CONCLUSIONS
  Magnetic fields with intensities as high as those used in this study are rare even in industrial working environments. In most cases, employees can return to work after implantation of a bipolar pacemaker or an ICD, after an appropriate risk assessment. Pacemakers programmed to unipolar configurations can cause danger to their users in environments with high electromagnetic fields, and should be avoided, if possible.
authors.affiliation: Safe New Technologies, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland. maria.tiikkaja@ttl.fi
authors.forename: Maria
authors.initials: M
authors.lastname: Tiikkaja
authors.forename: Aapo L
authors.initials: AL
authors.lastname: Aro
authors.forename: Tommi
authors.initials: T
authors.lastname: Alanko
authors.forename: Harri
authors.initials: H
authors.lastname: Lindholm
authors.forename: Heli
authors.initials: H
authors.lastname: Sistonen
authors.forename: Juha E K
authors.initials: JE
authors.lastname: Hartikainen
authors.forename: Lauri
authors.initials: L
authors.lastname: Toivonen
authors.forename: Jukka
authors.initials: J
authors.lastname: Juutilainen
authors.forename: Maila
authors.initials: M
authors.lastname: Hietanen
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003296:Cooking; D017147:Defibrillators, Implantable; D004574:Electromagnetic Fields / Q000009:adverse effects*; D022062:Electrophysiologic Techniques, Cardiac; D004781:Environmental Exposure; D004867:Equipment Design; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D016273:Occupational Exposure; D010138:Pacemaker, Artificial; D011474:Prosthesis Design; D011475:Prosthesis Failure; D014896:Welding; D055815:Young Adult