scholarly journals Effect of electroMagnetic Interference from smartPHone On cardiac implaNtable Electronic device (EMI-PHONE study)

2021 ◽  
Author(s):  
Sanatcha Apakuppakul ◽  
Sirin Apiyasawat ◽  
Nilubon Methachittiphan
Keyword(s):  
Adverse Events ◽  
Electromagnetic Interference ◽  
Electronic Device ◽  
Electronic Devices ◽  
Lead Level ◽  
Cardiac Implantable Electronic Device ◽  
Current Generation ◽  
Cardiac Implantable Electronic Devices ◽  
Ventricular Lead ◽  
Icd Shock

Abstract Background: Smartphones can emit two types of electromagnetic waves, static field from magnet and dynamic field from calling. Previous evidence showed the interference effects from old generation of mobile phones to cardiac implantable electronic device (CIEDs). The current generation of smartphones and CIEDs are reportedly better designed to reduce electromagnetic interference (EMI). We seek to find the presence and the magnitude of EMI from the current generation of smartphones. Objectives: The primary objective was to find out the presence and the effect of electromagnetic interference from current generation smartphones on cardiac implantable electronic devices (CIEDs). The secondary objectives were to demonstrate safety of using current generation smartphones on cardiac implantable electronic devices (CIEDs). Methods: A total of 80 subjects with CIEDs (Pacemaker, ICD, CRT-D, CRT-P) were recruited from our CIEDs clinic. Each subject was tested with three different smartphones (Nokia 3310, Iphone 7, and Samsung Galaxy S9), resulted in a total of 240 tests. Each phone was placed on chest wall, at pulse generator site, at atrial lead level, and at ventricular lead level. During the tests, real-time interrogations were performed to detect any EMI from smartphones in stand-by mode, and during calling-in and out for 30 seconds. After the tests, post-test interrogation was performed to detect any parameters changes. Adverse events including pacemaker inhibition, false ICD shock, CIEDs device malfunction, and urgent electro- physiologist consultations were recorded. Results: 80 subjects (Mean age 70.5 year-old, 50% male) were recruited in the study, and all completed 240 tests according to our protocol. The most common type of CIEDs tested was pacemaker (N=56, 70%), followed by ICD (N=16, 20%), and CRT (N=8, 10%). Most patients (N=62, 77.5%) had more than one lead implanted. The mean age of CIEDs implantation was 5.2 years (Devices were implanted since 2008-2019). Of all the tests performed, no electromagnetic interference (EMI) or adverse events was observed. Conclusion: Current generation of smartphones have no EMI effect to CIEDs and can be used safely without any adverse events including pacemaker inhibition, false ICD shock and CIEDs malfunction.

Avoiding implant complications in cardiac implantable electronic devices: what works?

EP Europace ◽  
2020 ◽  
Author(s):  
Maria Hee Jung Park Frausing ◽  
Mads Brix Kronborg ◽  
Jens Brock Johansen ◽  
Jens Cosedis Nielsen
Keyword(s):  
Primary Prevention ◽  
Electronic Device ◽  
Electronic Devices ◽  
Evidence Base ◽  
Cardiac Implantable Electronic Device ◽  
Cardiac Implantable Electronic Devices ◽  
What Works ◽  
Preventive Actions ◽  
Implant Complications ◽  
Patients Experience

Abstract Nearly one in ten patients experience complications in relation to cardiac implantable electronic device (CIED) implantations. CIED complications have serious implications for the patients and for the healthcare system. In light of the rising rates of new implants and consistent rate of complications, primary prevention remains a major concern. To guide future efforts, we sought to review the evidence base underlying common preventive actions made during a primary CIED implantation.

Cardiac implantable electronic device remote monitoring in a large cohort of patients and the need for planning

2020 ◽  
Vol 16 (5) ◽  
pp. 447-456
Author(s):  
Franco Zoppo ◽  
Antonio Lupo ◽  
Giacomo Mugnai ◽  
Francesca Zerbo
Keyword(s):  
Atrial Fibrillation ◽  
Remote Monitoring ◽  
Electronic Device ◽  
Descriptive Analysis ◽  
Electronic Devices ◽  
Standard Of Care ◽  
Large Cohort ◽  
Cardiac Implantable Electronic Device ◽  
Cardiac Implantable Electronic Devices

Aim: The remote monitoring (RM) of cardiac implantable electronic devices (CIED) is standard of care. We describe an organizational and projection RM workload model. Methods: At the time of the analysis (2015), 3995 CIED patients were followed-up; 1582 (40.5%) with RM. All RM transmissions (Tx) have been gathered in five event types. Results: We received 10,406 Tx, classified as: 128 (1.2%) red alerts, 141 (1.3%) atrial fibrillation episodes, 1944 (18.6%) yellow alerts, 403 (3.9%) lost Tx (disconnected/noncompliant patients) and 7790 (75.0%) Tx ‘OK' (un-eventful Tx). At the time of 100% of remote CIED managed, we can expect a total of 25,990 Tx/year. Conclusion: We provide a descriptive analysis of remote monitoring management and workload estimation in a large cohort of CIED patients.

Abstract 103: A Meta Analysis of Antibiotic Envelope Use to Prevent Cardiac Implantable Electronic Device Infections

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Muhammad U Khan ◽  
Ahmad Naeem Lone ◽  
Muhammad Khan ◽  
shahul valavoor ◽  
Muhammad Munir ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Electronic Device ◽  
Meta Analysis ◽  
Electronic Devices ◽  
Control Group ◽  
Preventive Strategy ◽  
Cardiac Implantable Electronic Device ◽  
Cardiac Implantable Electronic Devices ◽  
Device Infection ◽  
Effective Preventive Strategy

Introduction: Cardiac Implantable Electronic Device (CIED) infections are a major source of morbidity, mortality and increased healthcare cost. There are several well established risk factors associated with increased infection. An antibiotic coated envelope has been developed as an infection prevention intervention. Hypothesis: Whether antibiotic coated envelope is an effective preventive strategy against Cardiac Implantable Electronic Device Infections. Methods: 6 trials comparing use of antibiotic envelope to control, including 1 randomized trial and 5 cohort studies were selected using PubMed and Embase data bases through May 2019. The efficacy end point was prevention of CIED Infection. Outcomes were combined using random effects model and estimated by odds ratio with 95% confidence intervals (CI). Results: In our analysis of total 12,024 patients undergoing CIED implantation, 5,844 patients received antibiotic envelope while 6,180 patients were included in the control group. Antibiotic envelope was superior to control in reducing the risk of device infection (OR 0.40 CI [0.17-0.95], p=0.04). Conclusions: The use of antibiotic envelope in Cardiac Implantable Electronic Devices (CIED) is associated with reduced incidence of CIED infection.

scholarly journals Upper extremity dysfunctions in patients with cardiac implantable electronic devices: a systematic review

2021 ◽  
Vol 28 (7) ◽  
pp. 1-18
Author(s):  
Praveen Jayaprabha Surendran ◽  
Prasobh Jacob ◽  
Dineshkumar Selvamani ◽  
Theodoros Papasavvas ◽  
Narasimman Swaminathan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Electronic Device ◽  
Electronic Devices ◽  
Cochrane Central Register ◽  
Cardiac Implantable Electronic Device ◽  
Cardiac Implantable Electronic Devices ◽  
Shoulder Range Of Motion

Background/Aims The prevalence of cardiac implantable electronic devices has risen considerably during recent years. This has revolutionised the treatment of cardiac arrhythmias, which in turn reduced the incidence of sudden cardiac death. There are several complications associated with cardiac implantable electronic device implantation. Upper extremity dysfunction is one of the complications associated with this procedure and it should be addressed, since it can affect activities of daily living. This systematic review analysed the prevailing evidence pertaining to the common upper extremity dysfunctions associated with receiving a cardiac implantable electronic device. Methods A comprehensive literature search was conducted using PubMed, Cochrane Central Register of Controlled Trials, EMBASE (through Cochrane) and Google Scholar for original research published in the English language. The Rayyan QCRI web application was used for study selection and the decision-making process. PRISMA guidelines were used to conduct and report this review. The methodological quality of the included studies was appraised using the Newcastle–Ottawa Scale and Joanna Briggs Institute critical appraisal tool for analytic cross-sectional studies and case reports. Results This systematic review included eight studies with a total of 696 participants. The most common upper extremity dysfunctions associated with receiving a cardiac implantable electronic device were pain and limitation of shoulder range of motion. Limitation of range of motion could be persisted even in the long term after having a cardiac implantable electronic device implanted. Conclusions Contributing factors of upper extremity dysfunctions included size of the device, pectoral site of implantation and upper extremity immobilisation practices. Upper extremity dysfunction is an overlooked complication, as it received a relatively low priority, although it may negatively impact quality of life.

scholarly journals Cardiac Implantable Electronic Device Infections—Decision-Making Process in Complex Patients: Report of 3 Cases

2019 ◽  
Vol 7 ◽  
pp. 232470961983132
Author(s):  
Assad Mohammedzein ◽  
Aaisha Mozumder ◽  
Scott Milton
Keyword(s):  
Decision Making ◽  
Electronic Device ◽  
Early Recognition ◽  
Electronic Devices ◽  
Decision Making Process ◽  
High Morbidity ◽  
Entire System ◽  
Cardiac Implantable Electronic Device ◽  
Cardiac Implantable Electronic Devices ◽  
Complex Patients

Cardiac implantable electronic devices infections are becoming increasingly frequent with more of these devices being implanted in elderly patients with multiple comorbidities. They carry high morbidity and mortality if not treated promptly, which often entails removal of the entire system. Early recognition is paramount, and a multidisciplinary team is required. In this case report, we go through unique and challenging presentations of such patients with cardiac implantable electronic devices–related issues who presented to our institution, and we describe individual approaches to management and review the literature.

scholarly journals Identifying At‐Risk Patients for Sustained Atrial High‐Rate Episodes Using the C 2 HEST Score: The West Birmingham Atrial Fibrillation Project

2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Yan‐Guang Li ◽  
Daniele Pastori ◽  
Kazuo Miyazawa ◽  
Farhan Shahid ◽  
Gregory Y. H. Lip
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Electronic Device ◽  
Electronic Devices ◽  
Systolic Heart Failure ◽  
High Rate ◽  
Cardiac Implantable Electronic Device ◽  
The West ◽  
Cardiac Implantable Electronic Devices ◽  
Increased Risk

Background Sustained atrial high‐rate episodes (SAHREs) among individuals with a cardiac implantable electronic device are associated with an increased risk of adverse outcomes. Risk stratification for the development of SAHREs has never been investigated. We aimed to assess the performance of the C 2 HEST (coronary artery disease or chronic obstructive pulmonary disease [1 point each], hypertension [1 point], elderly [age ≥75 years, 2 points], systolic heart failure [2 points], thyroid disease [1 point]) score in predicting SAHREs in patients with cardiac implantable electronic devices without atrial fibrillation. Methods and Results Five Hundred consecutive patients with cardiac implantable electronic devices in the West Birmingham Atrial Fibrillation Project in the United Kingdom were followed since the procedure to observe the development of SAHREs, defined by atrial high‐rate episodes lasting >24 hours. Risk factors and incidence of SAHREs were analyzed. The predictive value of the C 2 HEST score for SAHRE prediction was evaluated. Over a mean follow‐up of 53.1 months, 44 (8.8%) patients developed SAHREs. SAHREs were associated with higher all‐cause mortality ( P <0.001) and ischemic stroke ( P =0.001). Age and heart failure were associated with SAHRE occurrence. The incidence of SAHREs increased by the C 2 HEST score (39% higher risk per point increase). Among patients with a C 2 HEST score ≥4, the incidence of SAHREs was 3.62% per year (95% CI, 2.14–5.16). The C 2 HEST score had moderate predictive capability (area under the curve, 0.73; 95% CI, 0.64–0.81) and discriminative ability (log‐rank P =0.003), which was better than other clinical scores (CHA 2 DS 2 ‐VASc, CHADS 2 , HATCH). Conclusions The C 2 HEST score predicted SAHRE incidence in patients without atrial fibrillation who had an cardiac implantable electronic device, with the highest risk seen in patients with a C 2 HEST score ≥4 The benefit of using the C 2 HEST score in clinical practice in this patient population needs further investigation.

Canadian Registry of Electronic Device Outcomes: remote monitoring outcomes in the Abbott battery performance alert—a multicentre cohort

EP Europace ◽  
2021 ◽  
Author(s):  
Sharath Kumar ◽  
Jason Davis ◽  
Bernard Thibault ◽  
Iqwal Mangat ◽  
Benoit Coutu ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Primary Outcome ◽  
Electronic Device ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Device Performance ◽  
Cardiac Implantable Electronic Devices ◽  
All Cause Mortality ◽  
Multicentre Cohort

Abstract Aims Cardiac implantable electronic devices with device advisories have the potential of device malfunction. Remote monitoring (RM) of devices has been suggested to allow the identification of abnormal device performance and permit early intervention. We sought to describe the outcomes of patients with and without RM in devices subject to the Abbott Premature Battery Depletion (PBD) advisory with data from a Canadian registry. Methods and results Patients with an Abbott device subject to the PBD advisory from nine implantable cardioverter defibrillator (ICD) implanting centres in Canada were included in the registry. The use of RM was identified from baseline and follow-up data in the registry. The primary outcome was detection of PBD and all-cause mortality. A total of 2666 patients were identified with a device subject to the advisory. In all, 1687 patients (63.2%) had RM at baseline. There were 487 deaths during follow-up. At a mean follow-up of 5.7 ± 0.7 years, mortality was higher in those without a remote monitor compared with RM at baseline (24.7% vs. 14.5%; P &lt; 0.001). Pre-mature battery depletion was identified in 36 patients (2.1%) with RM vs. 7 (0.7%) without RM (P = 0.004). Time to battery replacement was significantly reduced in patients on RM (median 5 vs. 13 days, P = 0.001). Conclusion The use of RM in patients with ICD and cardiac resynchronization therapy under advisory improved detection of PBD, time to device replacement, and was associated with a reduction in all-cause mortality. The factors influencing the association with mortality are unknown and deserve further study.

P4126Safety of magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices: A systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Padmanabhan ◽  
M Farwati ◽  
A Izath ◽  
A Al-Masry ◽  
D Kella ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Adverse Events ◽  
Meta Analysis ◽  
Electronic Devices ◽  
Binary Outcomes ◽  
Resonance Imaging ◽  
Pacing Threshold ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients

Abstract Recent guideline statements approve the performance of magnetic resonance imaging (MRI) in patients with non-conditional cardiac implantable electronic devices (CIEDs) under certain closely monitored conditions. Data from current registries may have lower power to discern changes that may occur in the CIED after the MRI. Objective We aimed to systematically review the literature to identify the adverse events and significance of changes in device function associated with performing MRI in patients with CIEDs Methods A comprehensive literature search of the databases was performed between 1980- 2017. Two independent reviewers selected studies and extracted data. A random-effects model was used for meta-analysis. Results A total of 7,422 patients underwent 8,865 MRI studies. No death occurred post MRI. Clinical adverse events were extremely rare (mostly less than 1%) and are summarized in Table 1. No significant changes in the pooled mean effect size estimate was noted for the changes in the lead parameters (pacing threshold, sensing and impedance) Binary outcomes post magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices Outcome Sample size Number of patients Rate SE LL of CI UL of CI Death 7401 0 0 0 0 0 Atrial arrhythmia 7173 10 0.001 0.0004 0.0007 0.0024 Ventricular arrhythmia 7371 9 0.0012 0.0004 0.0006 0.0022 Oversensing 4981 17 0.0034 0.0008 0.0020 0.0053 Inhibition of pacing 7371 6 0.0008 0.0003 0.0003 0.0016 Lead Failure/Generator Failure 7475/7475 2/8 0.0002/0.0011 0.0001/0.0004 0.0001/0.0005 0.0009/0.002 Power on Reset 1388 105 0.0131 0.0014 0.0107 0.0161 Did not complete scan 6851 13 0.0019 0.0005 0.0011 0.0031 Chest pain 7080 11 0.0021 0.0004 0.0008 0.0027. Lead threshold rise (>0.5v/>50%-A/V) 5076/6246 12/16 0.0024/0.0026 0.0007/0.0006 0.0013/0.0015 0.0040/0.0041 Change in Battery voltage >0.04V 7132 42 0.0061 0.0009 0.0043 0.0079 Sensing decrease >50%-A/V 5087/5834 17/9 0.0033/0.0015 0.0008/0.0005 0.0020/0.0008 0.0052/0.0028 Impedance changes >50ohms/>50% 5810 22 0.0038 0.0008 0.0024 0.0057 Rise in cardiac enzymes 1703 26 0.0152 0.0030 0.0102 0.0219 A, atrial; V, ventricular; SE, standard Error; LL, lower limit; UL, upper limit; CI, Confidence intervals. Conclusions MRI in patients with non-conditional CIEDs can be performed with high degree of safety and low rate of clinical events when performed under standardized protocols Acknowledgement/Funding None

Electric Cars and Electromagnetic Interference With Cardiac Implantable Electronic Devices: A Cross-sectional Evaluation

2018 ◽  
Vol 169 (5) ◽  
pp. 350 ◽  
Author(s):  
Carsten Lennerz ◽  
Matthew O'Connor ◽  
Lorenz Horlbeck ◽  
Jonathan Michel ◽  
Severin Weigand ◽  
...  
Keyword(s):  
Electromagnetic Interference ◽  
Electronic Devices ◽  
Cross Sectional ◽  
Electric Cars ◽  
Cardiac Implantable Electronic Devices
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