1. Beth Israel Deaconess Medical Center & Brigham & Women’s Hospital ICD Patient Support Group The 411 on iPODs: Electromagnetic Interference and Devices

2. Quick Review Normal Rhythm

3. Quick Review Abnormal Rhythm

5. Pacemaker Interference with iPOD MP3 Players Jay P. Thaker, Mehul B. Patel, MD, Haiyan Li, MD, Sujeeth R.Punnam, MD and Krit Jongnarangsin, MD. Michigan State University, Lansing, MI and University of Michigan, Ann Arbor, MI. Introduction: Pacemaker malfunction caused by cellular telephones and other sources is well described. The Apple mp3 players (iPods) have become ubiquitous worldwide. We conducted this prospective, single-blind study to evaluate potential interactions between iPods and pacemakers. Methods: Interactions between single and dual-chamber pacemakers (P) and 4 models of iPods (Third generation (3G), Photo, Video and Nano; all devices manufactured prior to 2006) were evaluated with P in the unipolar and bipolar configurations. Devices were tested in a random order. The technician monitoring the ECG/pacemaker telemetry screen was not aware of the P settings or the iPod being tested. Intracardiac electrograms and a surface ECG were monitored while the iPod was placed over the P for 5 - 10 seconds and was turned on and off. Interaction was categorized as over sensing (OS), telemetry interference (TI) and pacemaker inhibition (PI). Only reproducible events were counted. OS was defined as spurious atrial/ventricular sensed events on the marker channel associated with atrial/ventricular inhibition, mode switching or high atrial/ventricular rates on rate histograms. TI was defined as any other interference, which did not affect pacing function and was not detected by pacemaker interrogation. PI was defined as a failure to pace when pacing was expected.

6. Pacemaker Interference with iPOD MP3 Players Jay P. Thaker, Mehul B. Patel, MD, Haiyan Li, MD, Sujeeth R.Punnam, MD and Krit Jongnarangsin, MD. Michigan State University, Lansing, MI and University of Michigan, Ann Arbor, MI. Results: There were 83 patients (35F, 48M) with mean age of 76.1+/- 8.6 years with dual chamber P in 74 and single chamber P in 9. OS was seen in 20%, TI in 29% and PI in 1.2% of patients. OS and TI were persistent (>50% of application time) while PI was transient. OS and TI occurred more commonly with 3G and Photo in both unipolar and bipolar configurations. None of the patients reported any symptoms. Conclusions: We found interference in 50% of patients. Our observations are disconcerting because implantable pacemakers have become commonplace worldwide and the iPod has become a ubiquitous personal digital entertainment device. Other MP3 players may also possibly interact with pacemakers.

7. Pacemaker Interference with iPOD MP3 Players Jay P. Thaker, Mehul B. Patel, MD, Haiyan Li, MD, Sujeeth R.Punnam, MD and Krit Jongnarangsin, MD. Michigan State University, Lansing, MI and University of Michigan, Ann Arbor, MI. Results: 83 patients “tested” by placing iPOD directly over the pacemaker from 5-10 seconds while turning it on and off Over Sensing was seen in 20% (~17 patients) > 50% of the time the devices interacted Telemetry Interference in 29% (~24 patients) > 50% of the time the devices interacted Transient Pacemaker Inhibition in 1.2% (1 patient) None of the patients reported any symptoms Conclusions: We found interference in 50% of patients. Our observations are disconcerting because implantable pacemakers have become commonplace worldwide and the iPod has become an ubiquitous personal digital entertainment device. Other MP3 players may also possibly interact with pacemakers.

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15. Keep your ICD at least 6 inches from all of the previously listed devices.