title: Safety and interaction of patients with implantable cardiac defibrillators driving a hybrid vehicle.
abstract: BACKGROUND
  Electromagnetic interference (EMI) can affect the function of implantable cardioverter defibrillators (ICD). Hybrid electric vehicles (HEV) have increased popularity and are a potential source of EMI. Little is known about the in vivo effects of EMI generated by HEV on ICD.
  
  
  OBJECTIVE
  This study evaluated the in vivo interaction between EMI generated by HEV with ICD.
  
  
  RESULTS
  Thirty patients (73±9 y/o; 80% male) with stable ICD function were exposed to EMI generated by a Toyota Prius Hybrid®. The vehicle was lifted above the ground, allowing safe changes in engine rotation and consequent variations in electromagnetic emission. EMI was measured (NARDA STS® model EHP-50C) and expressed in A/m (magnetic), Volts/m (electrical), and Hertz (frequency). Six positions were evaluated: driver, front passenger, right and left back seats, outside, at the back and front of the car. Each position was evaluated at idle, 30 mph, 60 mph and variable speeds (acceleration-deceleration-brake). All ICD devices were continuously monitored during the study. The levels of EMI generated were low (highest mean levels: 2.09A/m at right back seat at 30 mph; and 3.5V/m at driver seat at variable speeds). No episode of oversensing or inadvertent change in ICD programming was observed.
  
  
  CONCLUSIONS
  It is safe for patients with ICD to interact with HEV. This is the first study to address this issue using an in vivo model. Further studies are necessary to evaluate the interaction of different models of HEV or electric engine with ICD or unipolar pacemakers.
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Fernando
authors.initials: F
authors.lastname: Tondato
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Jane
authors.initials: J
authors.lastname: Bazzell
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Linda
authors.initials: L
authors.lastname: Schwartz
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Mc Donald
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Fisher
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: S Shawn
authors.initials: SS
authors.lastname: Anderson
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Arcenio
authors.initials: A
authors.lastname: Galindo
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States.
authors.forename: Amylou C
authors.initials: AC
authors.lastname: Dueck
authors.affiliation: Heart Rhythm Section, Department of Cardiology, Mayo Clinic, AZ, United States. Electronic address: Scott.Luis@mayo.edu.
authors.forename: Luis R
authors.initials: LR
authors.lastname: Scott
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D001336:Automobiles; D017147:Defibrillators, Implantable; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012449:Safety
keywords: Electromagnetic interference; Hybrid car; Implantable-cardioverter defibrillator; Pacemaker