Heart Rhythm：iPod对心脏起搏器的影响

2008年4月的爱思唯尔期刊《心律》(Heart Rhythm)刊登了美国波士顿儿童医院的一项最新研究成果，它表明iPod播放器并不会干扰心脏起搏器的工作，这与之前其它有关的研究结果有着很大的分歧。

医生通常会提醒佩戴心脏起搏器的病人，在磁场、高电压线和电器周围保持警惕，因为所有电子产品在工作时都会产生不同程度的电波辐射。之前有研究表明iPod等便携播放器会干扰监测心脏起搏器。

近来，美国波士顿医院的研究人员对iPod播放器对心脏起搏器的影响做了大量的测试，测试的人群年龄跨度很大，他们心脏内都安置有起搏器或植入型心律转复除颤器。测试中，受试者都被要求处于躺卧状态以防止出现昏厥等意外状况发生。测试结果显示，所有受试者中都没有发现起搏器或植入型心律转复除颤器工作有任何异常。但是研究发现，有41％的患者的程控和遥测受到了干扰，程控是对于植入型起搏器进行无线遥控的方法，而遥测是对已埋植起搏器工作状态进行监测。同时研究显示，体积较大播放器造成的干扰比小体积的也要大，但如果距离身体6英寸之外则没有任何干扰。

研究人员认为，之所以最新研究与此前研究得到的结论不同，可能与对起搏器的测试方法不同有关。尽管之前研究显示iPod会对起搏器观测信号有干扰作用，可是并没有使起搏器停止工作。研究人员同时建议，最好不要长期长时间使用iPod等随身播放器，而且最好在使用时将其放置距身体6英寸远。（科学网于乃森/编译）

生物谷推荐原始出处：

(Heart Rhythm)，doi:10.1016/j.hrthm.2008.02.033，Gregory Webster, Charles I. Berul

Digital music players cause interference with interrogation telemetry for pacemakers and implantable cardioverter-defibrillators without affecting device function

Gregory Webster MD^a, Ligia Jordao RN^a, Maria Martuscello RN^a, Tarun Mahajan MD^a, Mark E. Alexander MD^a, Frank Cecchin MD^a, John K. Triedman MD, FHRS^a, Edward P. Walsh MD^a and Charles I. Berul MD, FHRS ^,^a^,

^aDepartment of Cardiology, Children’s Hospital, Boston and the Department of Pediatrics, Harvard Medical School, Boston, MA.

Background

Concern exists regarding the potential electromagnetic interaction between pacemakers, implantable cardioverter-defibrillators (ICDs) and digital music players (DMPs). A preliminary study reported interference in 50% of patients whose devices were interrogated near Apple iPods.

Objective

Given the high prevalence of DMP use among young patients, we sought to define the nature of interference from iPods and evaluate other DMPs.

Methods

Four DMPs (Apple Nano, Apple Video, SanDisk Sansa and Microsoft Zune) were evaluated against pacemakers and ICDs (PM/ICD). Along with continuous monitoring, we recorded a baseline ECG strip, sensing parameters and lead impedance at baseline and for each device.

Results

Among 51 patients evaluated (age 6 to 60 years, median 22), there was no interference with intrinsic device function. Interference with the programmer occurred in 41% of the patients. All four DMPs caused programmer interference, including disabled communication between the PM/ICD and programmer, noise in the ECG channel, and lost marker channel indicators. Sensing parameters and lead impedances exhibited no more than baseline variability. When the DMPs were removed six inches, there were no further programmer telemetry interactions.

Conclusions

Contrary to a prior report, we did not identify any evidence for electromagnetic interference between a selection of DMPs and intrinsic function of PM/ICDs. The DMPs did sometimes interfere with device-programmer communication, but not in a way that compromised device function. Therefore, we recommend that DMPs not be used during device interrogation, but suggest that there is reassuring counterevidence to mitigate the current high level of concern for interactions between DMPs and implantable cardiac rhythm devices.