Low frequency magnetic emissions and resulting induced voltages in a pacemaker by iPod portable music players

<p>Abstract</p> <p>Background</p> <p>Recently, malfunctioning of a cardiac pacemaker electromagnetic, caused by electromagnetic interference (EMI) by fields emitted by personal portable music players was highly publicized around the world. A clinical study of one patient was performed and two types of interference were observed when the clinicians placed a pacemaker programming head and an iPod were placed adjacent to the patient's implanted pacemaker. The authors concluded that "Warning labels may be needed to avoid close contact between pacemakers and iPods". We performed an in-vitro study to evaluate these claims of EMI and present our findings of no-effects" in this paper.</p> <p>Methods</p> <p>We performed in-vitro evaluations of the low frequency magnetic field emissions from various models of the Apple Inc. iPod music player. We measured magnetic field emissions with a 3-coil sensor (diameter of 3.5 cm) placed within 1 cm of the surface of the player. Highly localized fields were observed (only existing in a one square cm area). We also measured the voltages induced inside an 'instrumented-can' pacemaker with two standard unipolar leads. Each iPod was placed in the air, 2.7 cm above the pacemaker case. The pacemaker case and leads were placed in a saline filled torso simulator per pacemaker electromagnetic compatibility standard ANSI/AAMI PC69:2000. Voltages inside the can were measured.</p> <p>Results</p> <p>Emissions were strongest (≈ 0.2 μT pp) near a few localized points on the cases of the two iPods with hard drives. Emissions consisted of 100 kHz sinusoidal signal with lower frequency (20 msec wide) pulsed amplitude modulation. Voltages induced in the iPods were below the noise level of our instruments (0.5 mV pp in the 0 – 1 kHz band or 2 mV pp in the 0 – 5 MHz bandwidth.</p> <p>Conclusion</p> <p>Our measurements of the magnitude and the spatial distribution of low frequency magnetic flux density emissions by 4 different models of iPod portable music players. Levels of less than 0.2 μT exist very close (1 cm) from the case. The measured voltages induced inside an 'instrumented-can' pacemaker were below the noise level of our instruments. Based on the observations of our in-vitro study we conclude that no interference effects can occur in pacemakers exposed to the iPod devices we tested.</p

Radiated radiofrequency immunity testing of automated external defibrillators - modifications of applicable standards are needed

<p>Abstract</p> <p>Background</p> <p>We studied the worst-case radiated radiofrequency (RF) susceptibility of automated external defibrillators (AEDs) based on the electromagnetic compatibility (EMC) requirements of a current standard for cardiac defibrillators, IEC 60601-2-4. Square wave modulation was used to mimic cardiac physiological frequencies of 1 - 3 Hz. Deviations from the IEC standard were a lower frequency limit of 30 MHz to explore frequencies where the patient-connected leads could resonate. Also testing up to 20 V/m was performed. We tested AEDs with ventricular fibrillation (V-Fib) and normal sinus rhythm signals on the patient leads to enable testing for false negatives (inappropriate "no shock advised" by the AED).</p> <p>Methods</p> <p>We performed radiated exposures in a 10 meter anechoic chamber using two broadband antennas to generate E fields in the 30 - 2500 MHz frequency range at 1% frequency steps. An AED patient simulator was housed in a shielded box and delivered normal and fibrillation waveforms to the AED's patient leads. We developed a technique to screen ECG waveforms stored in each AED for electromagnetic interference at all frequencies without waiting for the long cycle times between analyses (normally 20 to over 200 s).</p> <p>Results</p> <p>Five of the seven AEDs tested were susceptible to RF interference, primarily at frequencies below 80 MHz. Some induced errors could cause AEDs to malfunction and effectively inhibit operator prompts to deliver a shock to a patient experiencing lethal fibrillation. Failures occurred in some AEDs exposed to E fields between 3 V/m and 20 V/m, in the 38 - 50 MHz range. These occurred when the patient simulator was delivering a V-Fib waveform to the AED. Also, we found it is not possible to test modern battery-only-operated AEDs for EMI using a patient simulator if the IEC 60601-2-4 defibrillator standard's simulated patient load is used.</p> <p>Conclusions</p> <p>AEDs experienced potentially life-threatening false-negative failures from radiated RF, primarily below the lower frequency limit of present AED standards. Field strengths causing failures were at levels as low as 3 V/m at frequencies below 80 MHz where resonance of the patient leads and the AED input circuitry occurred. This plus problems with the standard's' prescribed patient load make changes to the standard necessary.</p

Environmental, social and governance key performance indicators from a capital market perspective

"Extra-finanzielle, insbesondere ökologische, soziale und Corporate Governance (sog. ESG) Faktoren haben eine zunehmende Bedeutung innerhalb umfassender Unternehmensbewertungen. Diese Faktoren sind allerdings qualitativer Natur und erschweren demnach eine zahlenmäßige Darstellung, was eine Offenlegung und deren Aussagekraft für Investoren erschwert. Dieser Artikel erläutert zunächst die Kapitalmarktrelevanz von ESG-Aspekten und die damit verbundene Problematik. Darauf folgend werden aktuelle Bemühungen um verbesserte Offenlegung aufgezeigt und schließlich ökologische, soziale und Corporate Governance Leistungsindikatoren als richtungweisender Lösungsansatz dargestellt und kommentiert." (Autorenreferat)"Environmental, social and governance factors are becoming increasingly significant for comprehensive firm valuation. These factors are however of a qualitative nature and therefore difficult to express in numerical figures. Consequently, disclosure and the relevancy thereof to investors are problematic. The article analyses a breakthrough instrument which facilitates the quantification and representation of such data against the background of international institutional efforts aiming to promote standardised qualitative reporting for extra-financial information." (author's abstract

Antenna-coupled silicon-organic hybrid integrated photonic crystal modulator for broadband electromagnetic wave detection

In this work, we design, fabricate and characterize a compact, broadband and highly sensitive integrated photonic electromagnetic field sensor based on a silicon-organic hybrid modulator driven by a bowtie antenna. The large electro-optic (EO) coefficient of organic polymer, the slow-light effects in the silicon slot photonic crystal waveguide (PCW), and the broadband field enhancement provided by the bowtie antenna, are all combined to enhance the interaction of microwaves and optical waves, enabling a high EO modulation efficiency and thus a high sensitivity. The modulator is experimentally demonstrated with a record-high effective in-device EO modulation efficiency of r33=1230pm/V. Modulation response up to 40GHz is measured, with a 3-dB bandwidth of 11GHz. The slot PCW has an interaction length of 300um, and the bowtie antenna has an area smaller than 1cm2. The bowtie antenna in the device is experimentally demonstrated to have a broadband characteristics with a central resonance frequency of 10GHz, as well as a large beam width which enables the detection of electromagnetic waves from a large range of incident angles. The sensor is experimentally demonstrated with a minimum detectable electromagnetic power density of 8.4mW/m2 at 8.4GHz, corresponding to a minimum detectable electric field of 2.5V/m and an ultra-high sensitivity of 0.000027V/m Hz^-1/2 ever demonstrated. To the best of our knowledge, this is the first silicon-organic hybrid device and also the first PCW device used for the photonic detection of electromagnetic waves. Finally, we propose some future work, including a Teraherz wave sensor based on antenna-coupled electro-optic polymer filled plasmonic slot waveguide, as well as a fully packaged and tailgated device.Comment: 20 pages, 16 figure

In-vitro mapping of E-fields induced near pacemaker leads by simulated MR gradient fields

<p>Abstract</p> <p>Background</p> <p>Magnetic resonance imaging (MRI) of patients with implanted cardiac pacemakers is generally contraindicated but some clinicians condone scanning certain patients. We assessed the risk of inducing unintended cardiac stimulation by measuring electric fields (E) induced near lead tips by a simulated MRI gradient system. The objectives of this study are to map magnetically induced E near distal tips of leads in a saline tank to determine the spatial distribution and magnitude of E and compare them with E induced by a pacemaker pulse generator (PG).</p> <p>Methods</p> <p>We mapped magnetically induced E with 0.1 mm resolution as close as 1 mm from lead tips. We used probes with two straight electrodes (e.g. wire diameter of 0.2 mm separated by 0.9 mm). We generated magnetic flux density (B) with a Helmholtz coil throughout 0.6% saline in a 24 cm diameter tank with (dB/dt) of 1 T/sec (1 kHz sinusoidal waveform). Separately, we measured E near the tip of leads when connected to a PG set to a unipolar mode. Measurements were non-invasive (not altering the leads or PG under study).</p> <p>Results</p> <p>When scaled to 30 T/s (a clinically relevant value), magnetically-induced E exceeded the E produced by a PG. The magnetically-induced E only occurred when B was coincident with or within 15 msec of implantable pacemaker's pulse.</p> <p>Conclusions</p> <p>Potentially hazardous situations are possible during an MR scan due to gradient fields. Unintended stimulation can be induced via abandoned leads and leads connected to a pulse generator with loss of hermetic seal at the connector. Also, pacemaker-dependent patients can receive drastically altered pacing pulses.</p

Piezoelectric and optical setup to measure an electrical field: Application to the longitudinal near-field generated by a tapered coax

We propose a new setup to measure an electrical field in one direction. This setup is made of a piezoelectric sintered lead zinconate titanate film and an optical interferometric probe. We used this setup to investigate how the shape of the extremity of a coaxial cable influences the longitudinal electrical near-field generated by it. For this application, we designed our setup to have a spatial resolution of 100 um in the direction of the electrical field. Simulations and experiments are presented

Do Media Players Cause Interference with Pacemakers?

Background Electrical devices generate electromagnetic fields that may interfere with pacemakers. Media players cause telemetry interference with pacemakers, but it is not known whether they cause direct interference with pacemakers. The purpose of this study was to examine the interaction between pacemakers and 3 different media players. Methods In this prospective, randomized study, 54 patients with dual chamber pacemakers who were in sinus rhythm underwent baseline observation, followed by observation under telemetry communication. These patients were then randomly evaluated with 3 media players (iPod 3G, iPod Photo, and iPod Touch Apple, Cupertino, CA) with and without telemetry communication for 1 minute each. Patients were monitored for pacemaker malfunction using a single-channel ECG during exposure to media players. The pacemaker was interrogated after each exposure and an interrogation report was printed for evaluation. Pacemaker interference was categorized as type I, II, or III. Types I and II interference described telemetry interference and type III interference was defined as any direct interference with pacemaker function or programmed parameters. Results A total of 54 patients (29 men and 25 women; mean age 77.2 ± 9.3 y) were evaluated. In total, of the 162 tests (for telemetry interference) 36.4% were positive (Type I and II). Type III interference was also evaluated in 162 tests and none showed any evidence of direct interference. Conclusion Media players cause telemetry interference with pacemakers, but they do not directly interfere with pacemaker function. Copyright © 2009 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64532/1/20625_ftp.pd

Characteristics of Telemetry Interference with Pacemakers Caused by Digital Media Players

Background: Contemporary implantable heart rhythm devices communicate multiple complex data simultaneously using radiofrequency telemetry. Interference in communication can expose them to the risk of potential corruption, leading to adverse clinical consequences. Methods & Results: We studied the characteristics of interference with uplink (real time intracardiac electrograms, marker channel, and stored histograms) and downlink (attempt to program a change in the lower rate limit, the pacing mode, and the ventricular lead configuration) data transmission between the wand and the pacemaker caused by digital media players (iPods—Photo and 3G) in 50 patients. We also measured and characterized worst-case magnetic field emissions (MFE) from the wand (≤0.4 μT), pacemaker (≤0.004 μT), and iPod (≤0.05 μT) during telemetry to understand the modulation techniques and safety protocols employed during data transmission. Telemetry interference (TI) manifested as high-frequency spikes (24.4%), blanking (17.7%) and interruption (22.2%), or delay (17.6%) in transmission with warning on programmer's screen. TI occurred in 25.6% of patients when the iPod was “on” and in 13% even with the iPod turned “off.” There were no inaccuracies in downlinked data when the downlink communication was successful. Wanded telemetry utilizes low-frequency (30–300 kHz) radiowaves and simple digital modulation techniques at relatively slow rates for “sequential” data transmission protected by a continuous “handshake.” Emissions from iPods in that range interrupt the telemetry link but are too weak to cause pacemaker malfunction through corruption of vital data. Conclusion: Low-power MFE from iPods can produce interference with establishment and maintenance of a telemetry link and can cause TI with transmission of real time data, but because of continuous check protocols, do not corrupt the stored and vital downlink data. (PACE 2010; 33:712–720)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78697/1/j.1540-8159.2009.02672.x.pd