Skip to main content
SpringerLink
Log in

Electromagnetic interference in implantable cardioverter defibrillators: present but rare

  • Original Paper
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

A Correction to this article was published on 17 January 2020

This article has been updated

Abstract

Purpose

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Change history

  • 17 January 2020

    The original version of this article unfortunately contained a mistake.

References

  1. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, Levine JH, Saksena S, Waldo AL, Wilber D, Brown MW, Heo M (1996) Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med 335:1933–1940. doi:10.1056/NEJM199612263352601

    Article  CAS  PubMed  Google Scholar 

  2. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, Domanski M, Troutman C, Anderson J, Johnson G, McNulty SE, Clapp-Channing N, Davidson-Ray LD, Fraulo ES, Fishbein DP, Luceri RM, Ip JH, Sudden Cardiac Death in Heart Failure Trial I (2005) Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 352:225–237. doi:10.1056/NEJMoa043399

    Article  CAS  PubMed  Google Scholar 

  3. Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, Carson P, DiCarlo L, DeMets D, White BG, DeVries DW, Feldman AM, Comparison of Medical Therapy P, Defibrillation in Heart Failure I (2004) Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 350:2140–2150. doi:10.1056/NEJMoa032423

    Article  CAS  PubMed  Google Scholar 

  4. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, 3rd, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO, Smith SC, Jr., Jacobs AK, Adams CD, Anderson JL, Buller CE, Creager MA, Ettinger SM, Faxon DP, Halperin JL, Hiratzka LF, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura RA, Ornato JP, Page RL, Riegel B, Tarkington LG, Yancy CW, American College of Cardiology/American Heart Association Task Force on Practice G, American Association for Thoracic S, Society of Thoracic S (2008) ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation 117:e350–e408. doi: 10.1161/CIRCUALTIONAHA.108.189742

  5. Kolb C, Sturmer M, Sick P, Reif S, Davy JM, Molon G, Schwab JO, Mantovani G, Dan D, Lennerz C, Borri-Brunetto A, Babuty D (2014) Reduced risk for inappropriate implantable cardioverter-defibrillator shocks with dual-chamber therapy compared with single-chamber therapy: results of the randomized OPTION study. JACC Heart Fail 2:611–619. doi:10.1016/j.jchf.2014.05.015

    Article  PubMed  Google Scholar 

  6. Shah H, Mezu U, Patel D, Flanigan S, Hreybe H, Adelstein E, Jain S, Lang V, Saba S (2013) Mechanisms of inappropriate defibrillator therapy in a modern cohort of remotely monitored patients. Pacing Clin Electrophysiol 36:547–552. doi:10.1111/pace.12101

    Article  PubMed  Google Scholar 

  7. Kleemann T, Becker T, Doenges K, Vater M, Senges J, Schneider S, Saggau W, Weisse U, Seidl K (2007) Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation 115:2474–2480. doi:10.1161/CIRCULATIONAHA.106.663807

    Article  PubMed  Google Scholar 

  8. Liu J, Brumberg G, Rattan R, Patel D, Adelstein E, Jain S, Saba S (2014) Longitudinal follow-up of implantable cardioverter defibrillator leads. Am J Cardiol 113:103–106. doi:10.1016/j.amjcard.2013.08.046

    Article  PubMed  Google Scholar 

  9. Rauwolf T, Guenther M, Hass N, Schnabel A, Bock M, Braun MU, Strasser RH (2007) Ventricular oversensing in 518 patients with implanted cardiac defibrillators: incidence, complications, and solutions. Europace 9:1041–1047. doi:10.1093/europace/eum195

    Article  CAS  PubMed  Google Scholar 

  10. Occhetta E, Bortnik M, Magnani A, Francalacci G, Marino P (2006) Inappropriate implantable cardioverter-defibrillator discharges unrelated to supraventricular tachyarrhythmias. Europace 8:863–869. doi:10.1093/europace/eul093

    Article  PubMed  Google Scholar 

  11. Beinart R, Nazarian S (2013) Effects of external electrical and magnetic fields on pacemakers and defibrillators: from engineering principles to clinical practice. Circulation 128:2799–2809. doi:10.1161/CIRCULATIONAHA.113.005697

    Article  PubMed  PubMed Central  Google Scholar 

  12. Pinski SL, Trohman RG (2002) Interference in implanted cardiac devices, Part I. Pacing Clin Electrophysiol 25:1367–1381

    Article  PubMed  Google Scholar 

  13. Pinski SL, Trohman RG (2002) Interference in implanted cardiac devices, part II. Pacing Clin Electrophysiol 25:1496–1509

    Article  PubMed  Google Scholar 

  14. Misiri J, Kusumoto F, Goldschlager N (2012) Electromagnetic interference and implanted cardiac devices: the medical environment (part II). Clin Cardiol 35:321–328. doi:10.1002/clc.21997

    Article  PubMed  Google Scholar 

  15. Misiri J, Kusumoto F, Goldschlager N (2012) Electromagnetic interference and implanted cardiac devices: the nonmedical environment (part I). Clin Cardiol 35:276–280. doi:10.1002/clc.21998

    Article  PubMed  Google Scholar 

  16. Fernengel A, Schwer C, Helber U, Dornberger V (2007) Inappropriate implantable cardioverter-defibrillator shock induced by electromagnetic interference while taking a shower. Clin Res Cardiol 96:393–395. doi:10.1007/s00392-007-0514-z

    Article  PubMed  Google Scholar 

  17. Hayes DL, Wang PJ, Reynolds DW, Estes M 3rd, Griffith JL, Steffens RA, Carlo GL, Findlay GK, Johnson CM (1997) Interference with cardiac pacemakers by cellular telephones. N Engl J Med 336:1473–1479. doi:10.1056/NEJM199705223362101

    Article  CAS  PubMed  Google Scholar 

  18. Von Olshausen G, Lennerz C, Grebmer C, Pavaci H, Kolb C (2014) Shock whilst gardening–implantable defibrillators and lawn mowers. QJM 107:147–149. doi:10.1093/qjmed/hct180

    Article  Google Scholar 

  19. Buiatti A, Pavaci H, Deisenhofer I, Kolb C (2013) Electromagnetic interference between a three-dimensional cardiac mapping system and an implantable cardioverter defibrillator. Clin Res Cardiol 102:781–783. doi:10.1007/s00392-013-0604-z

    Article  PubMed  Google Scholar 

  20. Hours M, Khati I, Hamelin J (2013) Interference between active implanted medical devices and electromagnetic field emitting devices is rare but Real: results of an Incidence Study in a Population of Physicians in France. Pacing Clin Electrophysiol 37:290–296. doi:10.1111/pace.12269

    Article  PubMed  Google Scholar 

  21. Kolb C, Zrenner B, Schmitt C (2001) Incidence of electromagnetic interference in implantable cardioverter defibrillators. Pacing Clin Electrophysiol 24:465–468

    Article  CAS  PubMed  Google Scholar 

  22. Moss AJ, Schuger C, Beck CA, Brown MW, Cannom DS, Daubert JP, Estes NA 3rd, Greenberg H, Hall WJ, Huang DT, Kautzner J, Klein H, McNitt S, Olshansky B, Shoda M, Wilber D, Zareba W, Investigators M-RT (2012) Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med 367:2275–2283. doi:10.1056/NEJMoa1211107

    Article  CAS  PubMed  Google Scholar 

  23. Saeed M, Hanna I, Robotis D, Styperek R, Polosajian L, Khan A, Alonso J, Nabutovsky Y, Neason C (2014) Programming implantable cardioverter-defibrillators in patients with primary prevention indication to prolong time to first shock: results from the PROVIDE study. J Cardiovasc Electrophysiol 25:52–59. doi:10.1111/jce.12273

    Article  PubMed  Google Scholar 

  24. Gasparini M, Proclemer A, Klersy C, Kloppe A, Lunati M, Ferrer JB, Hersi A, Gulaj M, Wijfels MC, Santi E, Manotta L, Arenal A (2013) Effect of long-detection interval vs standard-detection interval for implantable cardioverter-defibrillators on antitachycardia pacing and shock delivery: the ADVANCE III randomized clinical trial. JAMA 309:1903–1911. doi:10.1001/jama.2013.4598

    Article  CAS  PubMed  Google Scholar 

  25. Wilkoff BL, Fauchier L, Stiles MK, Morillo CA, Al-Khatib SM, Almendral J, Aguinaga L, Berger RD, Cuesta A, Daubert JP, Dubner S, Ellenbogen KA, Mark Estes NA, 3rd, Fenelon G, Garcia FC, Gasparini M, Haines DE, Healey JS, Hurtwitz JL, Keegan R, Kolb C, Kuck KH, Marinskis G, Martinelli M, McGuire M, Molina LG, Okumura K, Proclemer A, Russo AM, Singh JP, Swerdlow CD, Teo WS, Uribe W, Viskin S, Wang CC, Zhang S, Document R (2015) 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing: developed in partnership with and endorsed by the European Heart Rhythm Association (EHRA), the Asia Pacific Heart Rhythm Society (APHRS), and the Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE)-Latin American Society of Cardiac Pacing and Electrophysiology. Endorsed by the American College of Cardiology (ACC) and American Heart Association (AHA). Europace (Epub ahead of print). doi: 10.1093/europace/euv411

  26. Swerdlow CD, Asirvatham SJ, Ellenbogen KA, Friedman PA (2014) Troubleshooting implanted cardioverter defibrillator sensing problems I. Circ Arrhythm Electrophysiol 7:1237–1261. doi:10.1161/CIRCEP.114.002344

    Article  PubMed  Google Scholar 

  27. Kolb C, Schmieder S, Lehmann G, Zrenner B, Karch MR, Plewan A, Schmitt C (2003) Do airport metal detectors interfere with implantable pacemakers or cardioverter-defibrillators? J Am Coll Cardiol 41:2054–2059

    Article  PubMed  Google Scholar 

  28. Jilek C, Tzeis S, Vrazic H, Semmler V, Andrikopoulos G, Reents T, Fichtner S, Ammar S, Rassias I, Theodorakis G, Weber S, Hessling G, Deisenhofer I, Kolb C (2011) Safety of screening procedures with hand-held metal detectors among patients with implanted cardiac rhythm devices: a cross-sectional analysis. Ann Intern Med 155:587–592. doi:10.7326/0003-4819-155-9-201111010-00005

    Article  PubMed  Google Scholar 

  29. Napp A, Joosten S, Stunder D, Knackstedt C, Zink M, Bellmann B, Marx N, Schauerte P, Silny J (2014) Electromagnetic interference with implantable cardioverter-defibrillators at power frequency: an in vivo study. Circulation 129:441–450. doi:10.1161/CIRCULATIONAHA.113.003081

    Article  PubMed  Google Scholar 

  30. Goldschlager N, Epstein A, Friedman P, Gang E, Krol R, Olshansky B, North American Society of P, Electrophysiology Practice Guideline C (2001) Environmental and drug effects on patients with pacemakers and implantable cardioverter/defibrillators: a practical guide to patient treatment. Arch Intern Med 161:649–655

    Article  Google Scholar 

  31. Jacob S, Panaich SS, Maheshwari R, Haddad JW, Padanilam BJ, John SK (2011) Clinical applications of magnets on cardiac rhythm management devices. Europace 13:1222–1230. doi:10.1093/europace/eur137

    Article  PubMed  Google Scholar 

  32. Gifford J, Larimer K, Thomas C, May P, Stanhope S, Gami A (2014) Randomized controlled trial of perioperative ICD management: magnet application versus reprogramming. Pacing Clin Electrophysiol 37:1219–1224. doi:10.1111/pace.12417

    Article  PubMed  Google Scholar 

  33. Healey JS, Merchant R, Simpson C, Tang T, Beardsall M, Tung S, Fraser JA, Long L, van Vlymen JM, Manninen P, Ralley F, Venkatraghavan L, Yee R, Prasloski B, Sanatani S, Philippon F, Canadian Cardiovascular S, Canadian Anesthesiologists S, Canadian Heart Rhythm S (2012) Canadian Cardiovascular Society/Canadian Anesthesiologists’ Society/Canadian Heart Rhythm Society joint position statement on the perioperative management of patients with implanted pacemakers, defibrillators, and neurostimulating devices. Can J Cardiol 28:141–151. doi:10.1016/j.cjca.2011.08.121

    Article  PubMed  Google Scholar 

  34. Crossley GH, Poole JE, Rozner MA, Asirvatham SJ, Cheng A, Chung MK, Ferguson TB Jr, Gallagher JD, Gold MR, Hoyt RH, Irefin S, Kusumoto FM, Moorman LP, Thompson A (2011) The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management this document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Heart Rhythm 8:1114–1154. doi:10.1016/j.hrthm.2010.12.023

    Article  PubMed  Google Scholar 

  35. Powell BD, Asirvatham SJ, Perschbacher DL, Jones PW, Cha YM, Cesario DA, Cao M, Gilliam FR 3rd, Saxon LA (2012) Noise, artifact, and oversensing related inappropriate ICD shock evaluation: ALTITUDE noise study. Pacing Clin Electrophysiol 35:863–869. doi:10.1111/j.1540-8159.2012.03407.x

    Article  PubMed  Google Scholar 

  36. Weretka S, Michaelsen J, Becker R, Karle CA, Voss F, Hilbel T, Osswald BR, Bahner ML, Senges JC, Kuebler W, Schoels W (2003) Ventricular oversensing: a study of 101 patients implanted with dual chamber defibrillators and two different lead systems. Pacing Clin Electrophysiol 26:65–70

    Article  PubMed  Google Scholar 

  37. Swerdlow CD, Ellenbogen KA (2013) Implantable cardioverter-defibrillator leads: design, diagnostics, and management. Circulation 128:2062–2071. doi:10.1161/CIRCULATIONAHA.113.003920

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Gesa von Olshausen

  2. Institut für Medizinische Statistik und Epidemiologie, Technische Universität München, Munich, Germany

    Ina-Christine Rondak

  3. Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

    Carsten Lennerz, Verena Semmler, Christian Grebmer, Tilko Reents, Sonia Ammar-Busch, Alessandra Buiatti, Felix Bourier, Isabel Deisenhofer & Christof Kolb

Authors
  1. Gesa von Olshausen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ina-Christine Rondak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carsten Lennerz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Verena Semmler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Grebmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tilko Reents
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sonia Ammar-Busch
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alessandra Buiatti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Felix Bourier
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Isabel Deisenhofer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Christof Kolb
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gesa von Olshausen.

Ethics declarations

Conflict of interest

C.L. has received travel support from St. Jude Medical. V.S. has received travel support from Sorin Group and St. Jude Medical. C.G. has received travel support from Biotronik and St. Jude Medical. C.K. has received lecture honorary/travel support from Biotronik, Boston Scientific, Medtronic, St. Jude Medical and Sorin Group; he is (was) a consultant to Biotronik, Boston Scientific and Sorin Group, and performs/has performed clinical studies supported by Biotronik, Boston Scientific, Medtronic, Sorin and St. Jude Medical. The other authors have no conflict of interest.

Ethical standards

The local ethics committee approved the retrospective data extracting for publication.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

von Olshausen, G., Rondak, IC., Lennerz, C. et al. Electromagnetic interference in implantable cardioverter defibrillators: present but rare. Clin Res Cardiol 105, 657–665 (2016). https://doi.org/10.1007/s00392-016-0965-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-016-0965-1

Keywords

Search

Navigation