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Electromagnetic Interference (EMI) in the Workplace
Description
Boston Scientific adheres to the
Association for the Advancement
of Medical
Instrumentation (AAMI)
standards for testing of implantable
pacemakers, implantable
cardioverter
defibrillators
(ICD), or heart failure devices
(cardiac resynchronization
therapy-defibrillator
[CRT-D]
or
-pacemaker [CRT-P])
in the presence
of EMI. As such, these devices
incorporate
protection mechanisms
(filters)
to ensure normal
operation
in the presence
of most operating
equipment
in home, public
and
work
environments.
However,
some
workplace
environments
contain equipment
that may
produce
large
levels of electromagnetic
energy
and
subsequently
interfere
with the
operation of the
implanted
device.
While
the majority
of
workplace
environments
will
not adversely
affect implantable
device
operation, EMI of significant
strength may
impact the performance
of the implanted
device, and could
potentially
lead to the following
temporary device responses:
|
Device
response |
ICDs / CRT-Ds |
Pacemakers
/ CRT-Ps |
|
Asynchronous
pacing |
■ |
■ |
|
Inhibition of pacing
(pacing therapy
not
provided when
needed) |
■ |
■ |
|
Inhibition of tachyarrhythmia
therapy (shock therapy
not provided
when needed) |
■ |
|
|
Inability to communicate
with the device |
■ |
■ |
|
Inappropriate
shocks
(shock therapy provided
when not
needed) |
■ |
|
|
Deactivation of shock
therapy |
■ |
|
|
Trigger ventricular
pacing at Maximum
Tracking Rate |
■ |
■ |
|
Trigger the
End-of-Life
indicator |
|
■ |
The
impact to device function
is typically
temporary;
if the
employee
(patient)
moves
away
from or
turns off
the EMI source, the implanted
device
resumes its normal mode of
operation.
In rare instances, the impact to the
device may
be permanent
such as memory
corruption
or reversion
to Safety
Mode operation.
Workplace
environmental
EMI testing
Because
EMI has the potential
to adversely
affect implanted
device performance,
some employers
may
request an environmental
EMI assessment (also called
site surveys)
of their
workplace
to assist in determining
if the patient
with
an implantable
device can return
to
work.
Allowing
a patient to resume
work
is a medical
decision, and
must be made cooperatively
by
the physician,
the employer
and the patient;
If an
environmental assessment
of the
workplace
is requested,
the EMI testing consultant
may
conduct a site survey
of the entire facility,
or may
conduct
testing on a single
piece
of equipment.
These
site surveys should
be conducted
in accordance
with
a broad range
of electromagnetic
specifications
and regulations,
and
will help
identify
EMI sources that may
interact
with
the patient’s device.
While we
can suggest site survey
agencies and provide
technical information to professional
testing consultants
regarding
operation and specifications
of our
devices,
Table
1 lists the EMI field measurements
of interest
with respect to evaluating
potential
interaction of certain
workplace
equipment
with
Boston Scientific implantable
devices.
Table
1. EMI
Field
Measurements
of
Interest for
Evaluating
|
Description |
Frequency |
|
Unit of Measurement
(RMS*) |
|
E-field†
strength |
Low |
Below 1
kHz |
Volts / meter (V/m) |
|
High |
500
kHz to
6 GHz |
||
|
H-field‡
strength |
DC (Static) |
0 Hz |
Gauss (G), Tesla (T), or
Amperes
(A) / meter (A/m) |
|
Low |
0.1 Hz to
3
kHz |
||
|
Power density |
High |
10 MHz to
300 GHz |
Watts (W) / meter^2
(W/m^2) |
*RMS
(Root Mean
Square) is a method
of
signifying
the amplitude
of
an electrical characteristic
such as magnetic
or electric
field
strength
†E-field
is a
static or
dynamic electric
field
‡H-field
is a
static or
dynamic magnetic
field
The
EMI testing consultant
will
typically
obtain the peak measurements
for the frequency
bands of interest
(as listed above) and compare
to reference
levels
found in
industry
standards
such as the International
Commission
on Non- Ionizing
Radiation
Protection
(ICNIRP) as shown
below
in Figure
1.
While
the ICNIRP guidelines
state that “compliance
with
the present
guidelines
may not
necessarily
preclude
interference
with,
or effects on, medical devices
such as…pacemakers
and defibrillators…,”
under ordinary
circumstances, it is Boston
Scientific’s belief
that exposure to electromagnetic
field strengths below
the reference
levels should
not interfere
with
the operation
of Boston Scientific implantable
devices. Please
note
that the effects of EMI can vary
based
on the physical
positioning
of the implanted
pulse
generator
and lead
system
within
a patient's
body;
therefore, safe operation
at
the
levels listed
above are
neither guaranteed
nor absolute.
494-522.