What you need to know about EMI Everyday questions about appliances and equipment that may interact with your device

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What you need to know about EMIEveryday
questions about appliances and equipment that may
interact with your device
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Topics

• What is EMI?
• How can EMI affect my device?
• What about magnets?
• To Use or Not Use How do I know?
• Who can I call with specific questions?

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What is EMI?

• Electromagnetic interference invisible lines of
  force
• Produced by combination of voltage (electricity)
  and current flow (magnetism)
• Signals may interfere with intended device
  operation

The strength of EMI is proportional to the
distance from the source. The closer you are, the
more of an effect EMI will have.
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What is EMI?

• Electric fields
• Produced by voltage
• Reduced in strength with increasing distance from
  the source

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What is EMI?

• Magnetic fields
• Produced by flow of current
• Electric field also present
• Reduced in strength with increasing distance from
  the source

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How can EMI affect my device?

• Implanted device may interpret EMI as rapid
  signal from heart
• Pacemaker may withhold pacing
• ICD may deliver unneeded shock
• Effects of EMI are temporary
• Does not usually harm device

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How can EMI affect my device?

• Most household appliances are not operated very
  close to the body.
• Elementary physics states that if you double the
  distance from the magnet, the magnetic field
  strength will be reduced (roughly) by a factor of
  8.

• At a distance of 12 in (30 cm) the EMI fields
  surrounding most household appliances are more
  than 100 times lower than recommended guidelines
  for public safety

A magnetic field of 10 G or more will be detected
by an implanted device.
World Health Organization, What is EMF?
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What about magnets?

• Magnets do the following things
• Attract certain materials - such as iron, nickel,
  cobalt, certain steels and other alloys
• Have an effect on electrical conductors when the
  magnet and conductor are moving in relation to
  each other

• Within six inches, a magnet may cause implanted
  devices to respond differently
• Pacemaker will respond by pacing at different,
  pre-set rate
• ICD will respond based on programming
• ICD may beep move away from object causing beep,
  call doctor

Pacemakers
ICDs
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To Use or Not Use How do you know?

• Implanted devices are designed to work properly
  around most appliances and equipment.
• Most things you handle or work near every day
  will not cause a problem.
• Topics to be covered
• Personal Items
• Kitchen, Tabletop, Household Items
• Office, Shop and Yard Equipment
• Entertainment Items
• Travel/Environment
• Dental and Medical Tests and Procedures

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Definitions

• Safe under normal use
• Only considered safe when used normally in
  accordance with their intended use.
• Check with your doctor for any additional
  restrictions that you may have for these items.
• Use precaution
• Getting too close to these items could affect
  your device when you are near any of these
  items, you should use precautions.
• Check with your doctor for detailed information
  before using these items.
• Do not use
• Strong electromagnetic and magnetic fields may
  affect your device.
• Talk to your doctor. For specific brand items,
  consult the original manufacturer for any
  interaction with implantable devices.

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Personal Items

• Safe under normal use
• Electric blankets, toothbrushes
• Hair dryers
• Heating pads
• Pagers
• Patient alert devices
• Personal digital assistants (PDAs, unless used as
  cell phone, see cell phone)

• Use precaution
• Cell phones
• Keep 6 inches from device
• Keep 12 inches from device if transmits more than
  3 watts
• Hold phone to ear on the opposite side of body
  from device
• Do not carry phone in breast pocket or belt
  within 6 inches of device
• Cordless phones, Electric razors
• Safe as long as not placed directly over device
• Hand-held massagers
• Safe as long as not placed directly over device

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Kitchen, Tabletop, Household Items

• Safe under normal use
• Air purifiers
• Blenders
• Clothes dryers
• Convection ovens
• Electric can openers
• Electric ovens and stoves
• Food processors
• Gas ovens and stoves
• Microwave ovens
• Portable space heaters
• Vacuum cleaners
• Washing machines

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Office, Shop and Yard Equipment

• Safe under normal use
• Copy machines
• Electric invisible fence
• Fax machines
• Personal computers

• Use precaution
• Keep 24 inches from device
• Arc welding equipment
• Running motors and alternators, especially those
  found in vehicles
• Avoid leaning over running motors and alternators
  of a running vehicle
• Keep 12 inches from device
• Battery-powered cordless power tools
• Chainsaws
• Corded drills and power tools
• Lawn mowers
• Leaf blowers
• Shop tools (drills, table saws, etc.)
• Snow blowers

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Entertainment Items

• Safe under normal use
• AM/FM radios
• CD/DVD players
• Hot tubs/whirlpools (with doctors permission)
• Laser tag games
• Multimedia players
• iPods, MP3 players
• Remote controls
• TV, garage door, stereo, camera/video equipment
• Tanning beds
• TVs and VCRs
• Video games

• Use precaution
• Bingo game magnetic wands
• Keep 6 inches from device
• CB and police radio antennas
• Keep 24 inches from device
• Slot machines
• Keep 12 inches from device
• Stereo speakers
• Keep 12 inches from device

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Travel/Environment

• Use precaution
• Security systems (i.e., airport, jail, courtroom)
• Walk through security archways normally
• Tell security personnel you have an implanted
  device and show Medical Device ID card
• Security wand should not be held over device more
  than about 30 seconds ask for hand-search if
  possible
• Theft detection systems (often in store and
  library entrances)
• Walk through theft detection systems at a normal
  pace
• Do not lean against or linger near these systems
• If you suspect interaction between your device
  and the theft detection systems, move away to
  decrease interference.

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Dental and Medical Tests and Procedures

• Safe under normal use
• Most medical and dental procedures will not
  affect your device. Some examples include
• Dental drills and cleaning equipment
• Diagnostic x-rays
• Electrocardiogram
• Mammography
• Inform technician you have device to ensure
  device does not get compressed
• Diagnostic ultrasound

• Use precaution
• Be especially careful with the following
  procedures
• CT Scans
• Electrocautery used in surgery
• External defibrillators
• Radiation therapy, lithotripsy
• TENS unit

Boston Scientific. A Closer Look. Computed
Tomography (CT) Scanning and Implantable
Pacemakers and Defibrillators) August 18, 2008.
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Do Not Use

• Personal Items
• Body fat measuring scales (hand-held)
• Magnetic mattresses or chairs
• Office, Shop and Yard Equipment
• Jackhammers
• Dental and Medical Tests and Procedures
• MRI Scans
• Diathermy
• Travel Entertainment
• Stun guns

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Specific questions?

• Specific appliances, tools, medical procedures or
  pieces of equipment
• Contact your doctor
• Other resources
• Patient Handbook
• Boston Scientific Patient Resources
  1.866.484.3268
• www.lifebeatonline.com

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Questions?

• What questions do you have about electromagnetic
  interference?

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Important Safety Information

• Cardiac Resynchronization Therapy Devices
• Cardiac resynchronization therapy pacemakers
  (CRT-P) and defibrillators (CRT-D) are used to
  treat heart failure patients who have symptoms
  despite the best available drug therapy. These
  patients also have an electrical condition in
  which the lower chambers of the heart contract in
  an uncoordinated way and a mechanical condition
  in which the heart pumps less blood than normal.
  CRT-Ps and CRT-Ds are not for everyone including
  people with separate implantable
  cardioverter-defibrillators (CRT-P only) or
  certain steroid allergies. Procedure risks
  include infection, tissue damage, and kidney
  failure. In some cases, the device may be unable
  to respond to your heart rhythm (CRT-P only) or
  may be unable to respond to irregular heartbeats
  or may deliver inappropriate shocks (CRT-D only).
  
• Implantable Cardioverter Defibrillators
• An implantable cardioverter defibrillator (ICD)
  can protect you from the effects of sudden
  cardiac arrest by reviving your heart rhythm. An
  ICD is not for everyone, including people with
  certain steroid allergies. Procedure risks
  include infection and tissue damage. In some
  cases, the device may not respond to irregular
  heartbeats or may deliver inappropriate shocks.
• Pacemakers
• A pacemaker system can monitor and treat your
  heart rhythm by delivering electrical energy to
  pace your heart when it senses a slow rhythm. A
  pacemaker is not for everyone, including patients
  with certain steroid allergies. Patients who have
  additional medical conditions that may not allow
  the pacemaker to function appropriately should
  not receive a device. Procedure risks include
  infection, tissue damage and kidney failure. In
  some cases, the device may not respond to your
  heart rhythm.
• For All Devices
• In rare cases severe complications or device
  failures can occur. Electrical or magnetic fields
  can affect the device. Only your doctor knows
  what is right for you. These devices are
  available by prescription only. Individual
  results may vary.
• Device Quality and Reliability
• It is Boston Scientifics intent to provide
  implantable devices of high quality and
  reliability. However, these devices may exhibit
  malfunctions that may result in lost or
  compromised ability to deliver therapy. Refer to
  Boston Scientifics CRM product performance
  report on www.bostonscientific.com for more
  information about device performance, including
  the types and rates of malfunctions that these
  devices have experienced historically. While
  historical data may not be predictive of future
  device performance, such data can provide
  important context for understanding the overall
  reliability of these types of products. Also, it
  is important that you talk with your doctor about
  the risks and benefits associated with the
  implantation of a device.
• (Rev. B)

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Thank you!

• This presentation was sponsored byBoston
  ScientificCardiac Rhythm Management
• We work to improve the quality of life for
  cardiac patients and those who care for them.