Potential sources of electromagnetic interference of pacemaker systems
| Environmental interaction | Potential interaction | Advice |
|---|---|---|
| Electronic antitheft surveillance devices | Pacemaker inhibition, undersensing or oversensing | Patient advised to move through devices quickly |
| Cellular telephones | Temporary asynchronous pacing or inhibition (only if device placed directly over generator) | Use of contralateral ear to device or use “hands free” device |
| High voltage generators or arc welding | Inhibition of pacing | Work environment assessed to quantify any possible interference |
| Magnetic resonance imaging (MRI) | Inhibition or asynchronous pacing, irreversible device malfunction, or lead displacement | Avoid |
| Electrocautery devices and diathermy | Inhibition of pacing and irreversible device malfunction. Increased pacing threshold | Use of bipolar diathermy, programming of device to fixed rate pacing before surgery if surgical field in proximity to pulse generator. Full assessment of device postoperatively |
| Therapeutic irradiation | Problems very rare but theoretically could cause irreversible malfunction | Shielding of device if close to irradiation field |
| Diagnostic radiology | No interaction | |
| Defibrillation | Potential irreversible device malfunction | Maintain defibrillation paddles as far from pulse generator as possible. Consider anteroposterior paddle positions |