E-Cigarettes May Contain Magnetic Component That Interferes with ICD Function: Report

Highlights

• A case analysis revealed that magnetic interference from an e-cigarette device can interfere with an ICD.
• The device caused several alerts that were registered when there were no clinical problems.
• Keeping the device 6 to 12 inches from an ICD for safety.

E-cigarettes worn in the left breast pocket interfere with the operation of implantable cardioverter defibrillators (ICDs), according to new research.

A new case analysis published in HeartRhythm Reports showed that a patient who use e-cigarettes was unaware of one of their integrated magnetic components, which interacted with his ICD several times before he finally reported it to his care providers.

“To our knowledge this is the first reported case of magnetic reversion of an ICD by an e-cigarette,” senior investigator Usha B. Tedrow, MD, MPH, and lead authors Julie B. Shea, MS, RNCS, Martin Aguilar, MD, and William Sauer, MD, from the Cardiovascular Arrhythmia Service at Brigham and Women’s Hospital and Harvard Medical School in Boston, said in a press release. “Given the increasing use of e-cigarettes worldwide, recognition of this potentially serious interaction appears clinically important.”

E-Cigarettes Interact, Caution Warranted

The case was that of a 48-year-old male who had an ICD that was producing beeps at times where there were no adverse symptoms. Remote monitoring showed the device functioning normally. Although the patient reported that there was no interaction between the e-cigarette device, remote monitoring data confirmed that there were interactions between the ICD and e-cigarette device (a JUUL vaping device).

“Magnets are ubiquitous in commercially-available electronic devices,” authors said. “They can be integrated in ways that are difficult to recognize. Although manufacturers are not routinely required to specify the strength of the magnetic fields and safety information for interference with medical-grade devices, the general recommendation is that any portable electronic or magnetic device be kept at least six to 12 inches away from an implant.”

The authors noted that several magnetic field meters, some available as smartphone apps, can be used to estimate the strength of a particular magnet. According to the researchers, most ICDs have a magnetic exposure upper limit of 10G. Device manufacturers typically recommend a 2:1 safety margin for clinical operation.

“Practitioners should remain vigilant regarding the use of new technology by their ICD patients,” cautioned the authors. “In our case, there was no adverse effect from the interaction of the e-cigarette with the device, but if it had happened during a tachycardia episode, it could have had serious, perhaps even fatal consequences.”