The safety of digital mobile cellular telephones with minute ventilation rate adaptive pacemakers.

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In vitro tests suggest that rate adaptive pacemakers using changes in transthoracic impedance to vary pacing rate may be affected by digital mobile telephones. Electromagnetic fields generated by digital mobile telephones (Global System for Mobile [GSM]) represent a potential source of electromagnetic interference (EMI) for the Telectronics META rate adaptive pacemakers, which use transthoracic impedance as a sensor to determine changes in minute ventilation. Sixteen implanted Telectronics META pulse generators were exposed to 25-W simulated GSM transmissions (900-MHz carrier pulsed at 2, 8, and 217 Hz with a pulse width of 0.6 ms) and the antenna of a 2-W digital mobile telephone (900-MHz, 217-Hz pulse, 0.6-ms pulse width). The 12 dual and four single chamber devices were programmed to maximum sensitivity and assessed in unipolar and bipolar settings and rate adaptive and nonrate adaptive modes. In all cases of EMI, testing was repeated at lower, more routinely set bipolar sensitivity levels. At maximum sensitivity, 11 of 16 devices displayed no evidence of EMI. Brief ventricular triggering occurred in 2, a brief pause in 1, a combination of both in 1, and a brief episode of pacemaker-mediated tachycardia in 1. With pulse generators programmed to more routine sensitivities, only one device displayed rare single beat ventricular triggering. No changes in minute ventilation rate adaptive pacing were observed. At maximum unipolar sensitivities, the META series of rate adaptive pacemakers are resistant to clinically important EMI from digital mobile telephones. Set at routine sensitivities, these devices perform reliably in the presence of digital mobile telephones.