Possible safety hazards with cardiac implantable electronic devices in those working in the aviation industry.

Abstract

In recent years, the number of patients who have been fitted with cardiac implantable electronic devices (CIEDs) has rapidly increased.1 Active CIEDs include cardiac pacemakers (that stimulate the heart in bradyarrhythmias); implantable cardioverter-defibrillators (ICDs; with the potential to deliver antitachycardic pacing and/or shocks in those at risk of ventricular tachyarrhythmias); devices for cardiac resynchronization therapy (with an additional left ventricular lead to resynchronize the heart by biventricular stimulation); and cardiac contractility modulation (that stimulate the right ventricular septum during the absolute refractory period, to improve contractility). The two latter CIEDs are used in those with heart failure and are usually not compatible with flying. Implantable loop recorders (ILR) are increasingly used for the investigation of palpitations and syncope2; although ILRs are only monitors and cannot affect the patient’s heart, they can also be affected by electromagnetic interference (EMI) and are remotely accessible. In both the civil and...