© The Board of Management and Trustees of the British Journal of Anaesthesia 2004
CORRESPONDENCE |
Pacemakers and defibrillators: anaesthetic implications
Editor—I read with interest the review article concerning the anaesthetic implications of pacemakers and defibrillators, by Salukhe, Dob and Sutton.1 I enjoyed reading the article and felt that it clarified a very complex topic that often causes much angst to anaesthetists, when presented with patients with implantable devices in situ.In the current climate, mobile telephones are becoming more accepted in the hospital and operating theatre environment. Many hospitals are now changing their policies involving the use of mobile phones in theatres, allowing their use at distances of 1 metre or more from anaesthetic machinery.
However, it must also be remembered the potential for mobile phones to interfere with pacemakers has been recognized for the past 10 yr.2 3 Interference of pacemaker function caused by electromagnetic interference (EMI) from mobile phones occurs mainly when the phone rings, or is switched on or off. The effect on pacemaker function may be inappropriate inhibition of pacing, triggering of pacing stimuli, reversion to asynchronous mode or change in the rate of pacing. Interference occurs most frequently when unipolar leads are used and when the device is programmed to a high sensitivity.4 Hayes and colleagues found that placing a mobile phone directly over a pacemaker caused interference in 20% of cases, and in 7.2% of cases caused symptoms.5
In view of the fact that mobile phone manufacturers advise keeping mobile phones >15 cm away from pacemakers, operating department personnel should be reminded of this fact and the potential for EMI-induced problems when looking after a patient with an implantable pacemaker in theatres.
London, UK
References
1 Salukhe TV, Dob D, Sutton R. Pacemakers and defibrillators: anaesthetic implications. Br J Anaesth 2004; 93: 95–104
2 Hayes DL, Von Feldt L, Neubauer S, Christiansen J, Rasmussen MJ. Effect of digital cellular phones on permanent pacemakers. Pacing Clin Electrophysiol 1995; 18: 863
3 Barbaro V, Bartolini P, Donato A, Militello C, Santini M. GSM and TACS cellular phones can alter pacemaker function. Bioelectromagnetics 17th Annual Meeting Abstract Book. Washington, DC, USA: Bioelectromagnetic Society, 1995; 24–6
4 Naegeli B, Osswald S, Deola M, Burkart F. Intermittent pacemaker dysfunction caused by digital mobile telephones. J Am Coll Cardiology 1996; 27: 1471–7[Abstract]
5 Hayes DL, Wang PJ, Reynolds DW. et al. Interference with cardiac pacemakers by cellular telephones. N Engl J Med 1997; 336: 1473–9
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