Abstract
Dermoscopy is currently used as an auxiliary tool in general dermatology. Since some commercially available dermoscopes have built-in magnets, electromagnetic interference (EMI) may occur when examining cardiac implantable electronic devices (CIED) patients. The aim of the study was to create maps of electromagnetic fields defining a safe distance in terms of EMI. The study was performed in laboratory conditions using measuring equipment specially designed for this purpose. The following dermoscopes have been tested: Illuco IDS-1100, Visiomed Luminis, Visiomed Luminis 2, Heine NC2 with and without a contact plate, DermLite DL4, and DermLite Handyscope. Measurements were made for the following set of lift-off distances: 5, 10, 20, 30, 40, 50, and 150 mm. Each 2D scan consisted of 10-line scans shifted from each other by 10 mm. The strength of the magnetic field decreased with the distance from the faceplate. The distribution of the magnetic field differed depending on the position of the magnets. The highest magnetic field was recorded in the center of the Heine NC2 faceplate (up to 8 mT). In most cases, at a distance of 10 mm, the magnetic field strength was measured below 1 mT, with the exception of Heine NC2 and Heine NC2 with a contact plate. All tested dermoscopes generated a magnetic field of <1 mT at the distance of 20 mm. The use of dermoscopes with built-in magnets may affect the functioning of CIEDs, and the impact may vary depending on the type of dermoscope.
Highlights
Dermoscopy, apart from its traditional application in the diagnostics of skin neoplasia, is currently used as an auxiliary tool in general dermatology, and the dermoscope is compared to the dermatologist’s stethoscope [1]
The highest magnetic field was recorded for the Heine NC2 directly above its two magnets
The Visiomed Luminis and DermLite Handyscope were characterized by the lowest density of the generated magnetic flux and as the only two they did not exceed the value of 1 mT, which is indicated by cardiac implantable electronic devices (CIED) manufacturers as the threshold value for activating the magnetic switch in CIEDs
Summary
Dermoscopy, apart from its traditional application in the diagnostics of skin neoplasia, is currently used as an auxiliary tool in general dermatology, and the dermoscope is compared to the dermatologist’s stethoscope [1]. In parallel with the increasing use of dermoscopy, due to the more frequent incidence of skin cancer, the number of patients treated with cardiac implantable. CIEDs include cardiac pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. Since some commercially available dermoscopes have built-in magnets, possible electromagnetic interference (EMI) may occur when examining a CIED patient, including sensing disturbances (undersensing or oversensing), asynchronous pacing, increased pacing rate, pacing inhibition, and running the mode switch function. Atrial oversensing may trigger inadequate ventricular pacing [2]. Ventricular oversensing can inhibit pacing, a potentially life-threatening condition in a pacemaker-dependent patients [3]. In patients with implanted ICD, ventricular oversensing may lead to inadequate therapy (anti-tachycardia pacing or high voltage shock). Inappropriate ICD therapies can be potentially proarrhythmic and harmful, and are associated with worse prognosis [4]
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