Electromagnetic Interference: Sources, Recognition, and Management

Potential sources of electromagnetic interference (EMI), often a concern for patients with cardiac devices, are often misdirected because of myth or hype by the mediaThe surgical suite, in particular, has several sources of potential EMI and therefore periprocedural management of cardiac implantable electronic devices is critical to minimize potential unwanted effects on devicesThe most common responses to EMI are triggering or inhibition of pacemaker function, and false tachyarrhythmia detection in implantable cardioverter-defibrillatorsTransient EMI of sufficient strength can reprogram the pacing mode, as opposed to temporarily modifying functionThis is most commonly caused by external defibrillation or electrocautery, and occasionally by exposure to magnetic resonance imaging magnets, and, in contrast to noise reversion, pacing inhibition, or inappropriate shock, does not resolve when the EMI is discontinuedElectric and magnetic signals are emitted by industrial, hospital medical, and domestic sourcesEach of these environments is discussed individually in this chapter.