Effect of ElectroMagnetic interference from SmartPHone on cardiac ImplaNtable electronic device (EMI-PHONE study)

Background: Smartphone can emit two types of electromagnetic waves, static field and dynamic field. Evidence showed the interference from phones to cardiac implantable electronic devices (CIEDs). The smartphones and CIEDs are reportedly better designed to reduce electromagnetic interference (EMI). Methods: 80 consecutive subjects with CIEDs were recruited and tested for EMI. Subject was tested with three different smartphones (Nokia 3310, Iphone 7, and Samsung 9S). Phone was attached to chest wall at 0 cm at generator site, at atrial lead level, and at ventricular lead level. During the tests, real-time interrogations were performed to detect any EMI from smartphone in standby mode, and during calling-in and out for 30 s. After the tests, post-test interrogations were performed to detect any parameter change. Adverse events including pacemaker inhibition, false ICD shock, CIEDs device malfunction, and urgent electrophysiologist consultations were recorded. Results: 80 subjects (mean age 70.5-year-old, 50% male) recruited in the study, all completed the testing 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 year of implantation was 5.2 +/- 2.8 (devices were implanted from 2008 to 2019). Of all the tests performed, there was no EMI or adverse events observed. Conclusion: Current generation of smartphones has no EMI effect on CIEDs in our study and can be used safely with less concern about adverse events including pacemaker inhibition, inappropriate ICD shock, and CIEDs device malfunction.