Reliability of electromagnetic filters of cardiac pacemakers tested by cellular telephone ringing

BACKGROUND State-of-the art cardiac pacemakers are protected against radiofrequency signals. Although there have been earlier clinical and in vitro reports of cellular phone interference with implantable devices, only a few studies have been performed in recent years. The ringing phase of digital GSM or PCS cellular phones includes a brief period of peak radiated power. OBJECTIVES This study tested the protection offered by electromagnetic filters of cardiac pacemakers against cellular phone ringing. METHODS We performed 330 consecutive tests in 158 patients at the time of routine examination in our pacemaker follow-up clinic. The programmed parameters remained unchanged before testing. During electrocardiographic monitoring, 2 single-band digital cellular phones consecutively placed over the pacemaker pocket each received a call. The phone systems tested were 1) GSM at a maximal power output of 2 W, operating on a 900 MHz carrier frequency, and 2) PCS at a maximal output of 1 W, operating on a 1800 MHz carrier frequency. RESULTS Interference was noted in only 5 tests, due to interaction by the GSM system with 4 unprotected pacemaker models. The GSM test was negative in 12 other tests of identical pulse generator models. The overall incidence of interference was 1.5% of tests. CONCLUSIONS Interference by cellular phone ringing occurred only with unprotected pacemaker models. Standard programming of these unprotected models was associated with a low incidence of interference.