title: Electromagnetic interference in implantable cardioverter defibrillators: present but rare.
abstract: OBJECTIVE
  Electromagnetic interference (EMI) with implantable cardioverter defibrillators (ICDs) can cause oversensing and subsequently inappropriate ICD therapies. We retrospectively investigated the current incidence and clinical relevance of oversensing related EMI in a large cohort of ICD patients.
  
  
  METHODS
  From January 2005 to April 2013, all ICD interrogations performed at our institution were analyzed for the occurrence of oversensing related EMI. EMI episodes were classified as clinically significant, potentially significant or of minor significance. To identify risk factors for EMI, we also analyzed different lead models in our cohort (integrated vs true bipolar leads).
  
  
  RESULTS
  Data of 2940 ICD patients (mean age 63 ± 16 years, 2322 male patients, 7772 patient-years) were retrospectively analyzed for the occurrence of EMI. During the observation period, a total of 145 (hospital environment n = 97, non-hospital environment n = 48) episodes occurred and resulted in an overall EMI incidence, i.e. event rate, of 1.87 % per patient per year. Focusing on clinically significant or potentially significant episodes, the EMI incidence was 0.27 % per patient per year. Cox proportional hazards regression analysis did not reveal a statistically significant higher hazard of oversensing for patients with integrated bipolar leads compared to patients with true bipolar leads (HR = 2.21; 95 % CI 0.90-5.39; p = 0.083).
  
  
  CONCLUSIONS
  Our data demonstrate that EMI continues to occur in everyday life. Patients should be well informed about the potential sources and risks of EMI but they need not be overly concerned since the risk of EMI-especially in a non-hospital environment-is low.
authors.affiliation: 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. gesa.von-olshausen@lrz.tum.de.
authors.forename: Gesa
authors.initials: G
authors.lastname: von Olshausen
authors.affiliation: Institut für Medizinische Statistik und Epidemiologie, Technische Universität München, Munich, Germany.
authors.forename: Ina-Christine
authors.initials: IC
authors.lastname: Rondak
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Lennerz
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Semmler
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Grebmer
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Tilko
authors.initials: T
authors.lastname: Reents
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ammar-Busch
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Buiatti
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Bourier
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Deisenhofer
authors.affiliation: Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Kolb
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation*; D004574:Electromagnetic Fields / Q000009:adverse effects*; D022062:Electrophysiologic Techniques, Cardiac; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: Electromagnetic interference (EMI); ICD therapy; Implantable cardioverter defibrillator (ICD); Ventricular oversensing
references.citation: Clin Cardiol. 2012 May;35(5):276-80
references.pmid: 22539305
references.citation: N Engl J Med. 1996 Dec 26;335(26):1933-40
references.pmid: 8960472
references.citation: Pacing Clin Electrophysiol. 2014 Mar;37(3):290-6
references.pmid: 24033373
references.citation: JACC Heart Fail. 2014 Dec;2(6):611-9
references.pmid: 25282033
references.citation: Heart Rhythm. 2011 Jul;8(7):1114-54
references.pmid: 21722856
references.citation: N Engl J Med. 1997 May 22;336(21):1473-9
references.pmid: 9154765
references.citation: N Engl J Med. 2004 May 20;350(21):2140-50
references.pmid: 15152059
references.citation: Europace. 2007 Nov;9(11):1041-7
references.pmid: 17897927
references.citation: Circ Arrhythm Electrophysiol. 2014 Dec;7(6):1237-61
references.pmid: 25516582
references.citation: QJM. 2014 Feb;107(2):147-9
references.pmid: 24023069
references.citation: Clin Res Cardiol. 2007 Jun;96(6):393-5
references.pmid: 17453136
references.citation: Pacing Clin Electrophysiol. 2014 Sep;37(9):1219-24
references.pmid: 24802626
references.citation: Arch Intern Med. 2001 Mar 12;161(5):649-55
references.pmid: 11231696
references.citation: Pacing Clin Electrophysiol. 2012 Jul;35(7):863-9
references.pmid: 22519674
references.citation: J Am Coll Cardiol. 2003 Jun 4;41(11):2054-9
references.pmid: 12798581
references.citation: Europace. 2011 Sep;13(9):1222-30
references.pmid: 21616944
references.citation: N Engl J Med. 2012 Dec 13;367(24):2275-83
references.pmid: 23131066
references.citation: Circulation. 2007 May 15;115(19):2474-80
references.pmid: 17470696
references.citation: Pacing Clin Electrophysiol. 2002 Oct;25(10):1496-509
references.pmid: 12418748
references.citation: Pacing Clin Electrophysiol. 2002 Sep;25(9):1367-81
references.pmid: 12380774
references.citation: Pacing Clin Electrophysiol. 2013 May;36(5):547-52
references.pmid: 23437876
references.citation: Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 1):65-70
references.pmid: 12685142
references.citation: Clin Res Cardiol. 2013 Oct;102(10):781-3
references.pmid: 23900685
references.citation: Circulation. 2013 Oct 29;128(18):2062-71, 1-9
references.pmid: 24166415
references.citation: Clin Cardiol. 2012 Jun;35(6):321-8
references.pmid: 22539263
references.citation: JAMA. 2013 May 8;309(18):1903-11
references.pmid: 23652522
references.citation: Can J Cardiol. 2012 Mar-Apr;28(2):141-51
references.pmid: 22433577
references.citation: Europace. 2006 Oct;8(10):863-9
references.pmid: 16916859
references.citation: Am J Cardiol. 2014 Jan 1;113(1):103-6
references.pmid: 24176060
references.citation: N Engl J Med. 2005 Jan 20;352(3):225-37
references.pmid: 15659722
references.citation: Circulation. 2013 Dec 24;128(25):2799-809
references.pmid: 24366589
references.citation: Circulation. 2014 Jan 28;129(4):441-50
references.pmid: 24163067
references.citation: Ann Intern Med. 2011 Nov 1;155(9):587-92
references.pmid: 22041947
references.citation: J Cardiovasc Electrophysiol. 2014 Jan;25(1):52-9
references.pmid: 24112717
references.citation: Pacing Clin Electrophysiol. 2001 Apr;24(4 Pt 1):465-8
references.pmid: 11341083
references.citation: Circulation. 2008 May 27;117(21):e350-408
references.pmid: 18483207