Webster Gregory, Jordao Ligia, Martuscello Maria, Mahajan Tarun, Alexander Mark E, Cecchin Frank, Triedman John K, Walsh Edward P, Berul Charles I
Department of Cardiology, Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.
Heart Rhythm. 2008 Apr;5(4):545-50. doi: 10.1016/j.hrthm.2008.02.033. Epub 2008 Mar 4.
Concern exists regarding the potential electromagnetic interaction between pacemakers, implantable cardioverter-defibrillators (ICDs) and digital music players (DMPs). A preliminary study reported interference in 50% of patients whose devices were interrogated near Apple iPods.
Given the high prevalence of DMP use among young patients, we sought to define the nature of interference from iPods and evaluate other DMPs.
Four DMPs (Apple Nano, Apple Video, SanDisk Sansa and Microsoft Zune) were evaluated against pacemakers and ICDs (PM/ICD). Along with continuous monitoring, we recorded a baseline ECG strip, sensing parameters and lead impedance at baseline and for each device.
Among 51 patients evaluated (age 6 to 60 years, median 22), there was no interference with intrinsic device function. Interference with the programmer occurred in 41% of the patients. All four DMPs caused programmer interference, including disabled communication between the PM/ICD and programmer, noise in the ECG channel, and lost marker channel indicators. Sensing parameters and lead impedances exhibited no more than baseline variability. When the DMPs were removed six inches, there were no further programmer telemetry interactions.
Contrary to a prior report, we did not identify any evidence for electromagnetic interference between a selection of DMPs and intrinsic function of PM/ICDs. The DMPs did sometimes interfere with device-programmer communication, but not in a way that compromised device function. Therefore, we recommend that DMPs not be used during device interrogation, but suggest that there is reassuring counterevidence to mitigate the current high level of concern for interactions between DMPs and implantable cardiac rhythm devices.
人们担心起搏器、植入式心脏复律除颤器（ICD）与数字音乐播放器（DMP）之间可能存在电磁相互作用。一项初步研究报告称，在50%的设备靠近苹果iPod进行询问的患者中出现了干扰。
鉴于年轻患者中DMP的高使用率，我们试图确定iPod干扰的性质并评估其他DMP。
针对起搏器和ICD（PM/ICD）对四种DMP（苹果Nano、苹果Video、闪迪Sansa和微软Zune）进行了评估。除了持续监测外，我们在基线以及针对每种设备时记录了基线心电图条、感知参数和导联阻抗。
在评估的51例患者（年龄6至60岁，中位数22岁）中，未发现对设备固有功能的干扰。41%的患者出现了对编程器的干扰。所有四种DMP均导致编程器干扰，包括PM/ICD与编程器之间的通信中断、心电图通道中的噪声以及标记通道指示器丢失。感知参数和导联阻抗的变化不超过基线水平。当将DMP移开6英寸时，不再有编程器遥测交互。
与先前的报告相反，我们未发现所选DMP与PM/ICD的固有功能之间存在电磁干扰的任何证据。DMP有时确实会干扰设备与编程器之间的通信，但方式不会损害设备功能。因此，我们建议在设备询问期间不要使用DMP，但表明有令人安心的反证来减轻当前对DMP与植入式心律设备之间相互作用的高度关注。
