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World J Cardiol. Aug 26, 2022; 14(8): 446-453
Published online Aug 26, 2022. doi: 10.4330/wjc.v14.i8.446
Effects of medically generated electromagnetic interference from medical devices on cardiac implantable electronic devices: A review
Walker Barmore, Himax Patel, Cassandra Voong, Caroline Tarallo, Joe B Calkins Jr
Walker Barmore, Joe B Calkins Jr, Department of Cardiology, Augusta University Medical Center, Augusta, GA 30912, United States
Himax Patel, Cassandra Voong, Department of Internal Medicine, Augusta University Medical Center, Augusta, GA 30912, United States
Caroline Tarallo, Medical College of Georgia, Medical College of Georgia, Augusta, GA 30912, United States
Author contributions: Barmore W, Patel H, Voong C, and Tarallo C contributed equally to this work; Barmore W and Patel H designed the review article; Barmore W, Patel H, Voong C, and Tarallo C performed the research; Barmore W, Patel H, Voong C, Tarallo C, and Calkins Jr JB wrote the manuscript; all authors have read and approve the final manuscript.
Supported by the Gordon Chason Miller MD Cardiology Education Endowment Fund in the Medical College of Georgia Foundation.
Conflict-of-interest statement: All authors declare that there is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Walker Barmore, MD, Doctor, Department of Cardiology, Augusta University Medical Center, 1120 15th Street, Augusta, GA 30912, United States. wabarmore@augusta.edu
Received: April 26, 2022
Peer-review started: April 16, 2022
First decision: June 8, 2022
Revised: June 15, 2022
Accepted: August 15, 2022
Article in press: August 15, 2022
Published online: August 26, 2022
Processing time: 125 Days and 1.7 Hours
Abstract

As cardiac implantable electronic devices (CIED) become more prevalent, it is important to acknowledge potential electromagnetic interference (EMI) from other sources, such as internal and external electronic devices and procedures and its effect on these devices. EMI from other sources can potentially inhibit pacing and trigger shocks in permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD), respectively. This review analyzes potential EMI amongst CIED and left ventricular assist device, deep brain stimulators, spinal cord stimulators, transcutaneous electrical nerve stimulators, and throughout an array of procedures, such as endoscopy, bronchoscopy, and procedures involving electrocautery. Although there is evidence to support EMI from internal and external devices and during procedures, there is a lack of large multicenter studies, and, as a result, current management guidelines are based primarily on expert opinion and anecdotal experience. We aim to provide a general overview of PPM/ICD function, review documented EMI effect on these devices, and acknowledge current management of CIED interference.

Keywords: Electromagnetic interference; Pacemaker; Implantable cardioverter defibrillator; Permanent pacemakers; Cardiac implantable electronic devices; Left ventricular assist device; Endoscopy; Bronchoscopy; Electrocautery; Capsule endoscopy; Transcutaneous electrical nerve stimulators unit; Spinal cord stimulator

Core Tip: There are several infrequent yet significant sources of electromagnetic interference (EMI) on cardiac implantable electronic devices (CIED). These include both implantable devices and procedures. Patients with cardiac devices often may need another implanted medical device or specific medical procedures. The potential resulting EMI can be minimized in order to make these treatments safer and still provide patients with therapeutic relief. A large, prospective study is critical to provide more robust and consistent literature regarding EMI effects on CIED. This will provide a clearer assessment of risk of EMI associated with variety of sources in addition to the development of evidence based clinical guidelines regarding management of patients with CIED.