Digital cellular telephone interaction with implantable cardioverter-defibrillators

Objectives. This study sought to determine, in vivo, whether electromagnetic interference (EMI), generated by North American Digital Communications (NADC)/Time Division Multiple Access-50-Hz (TDMA 50) mobile cellular digital telephone model AT&T 6650, disturbs normal implantable cardioverter defibrillator (ICD) operation and to verify these observations in vitro by testing a selection of telephones representing worldwide systems. Methods. The effects of cellular phone interference on the operation of various models of market-released ICDs from a single manufacturer, Medtronic, Inc., were tested. The in vivo clinical test was undertaken in 41 patients using the AT&T 6650 digital telephone with the NADC/TDMA-50 technology. The in vitro component of the study was examined twofold: 1) antenna generated far field; and 2) analog/digital cellular telephone near field, Results. None of the ICDs tested in 41 patients were affected by oversensing of the EMI field of the cellular telephones during the in vivo study. Therefore, the binomial upper 95% confidence limit for the failure rate of 0% is 7%. The in vitro antenna-generated field testing showed that telephone modulation frequencies used in the international Global System Mobile and TDMA-50 cellular telephone technologies did not result in ICD sensing interference at the predicted electric field intensity. The in vitro near held tests were performed using both analog and digital cellular telephones in service, or in the test mode, and indicated no interaction with normal operation. However, the static magnetic field generated by the cellular telephone placed over the ICD at a distance less than or equal to 0.5 cm will activate the internal reed switch, resulting in temporary suspension of ventricular tachycardia and fibrillation detection. Conclusions. We conclude that TDMA-50 cellular telephones did not interfere with these types of ICDs. However, we recommend that the patient not carry or place the digital cellular telephone within 15 cm (6 in.) of the ICD. (C) 1998 by the American College of Cardiology.