Pacemakers and implantable defibrillators

Many patients have pacemakers implanted for a number of medical reasons.   There is also an increasing number of implantable defibrillators (ICDs) being used, although some people feel that too many are being implanted.   The pacemakers provide an electrical signal to meke ther heart beat, and can either just pace the ventricle  (the major pumping chamber) or dual chamber where the receiving chamber (atrium) is stimulated and then the ventricle.  There are also unipolar or bipolar leads, unipolar are more sensitive to outside interference.   Implantable defibrillators detect if the heart develops a serious potentially fatal rhythm (usually ventricular fibrillation or rapid ventricular tachycardia), and administer a shock to put it back into the normal rhythm.  There is a switch in the pacemaker which puts the pacemaker into an asynchronous mode where it beats at a fixed rate.  This is used to test the pacemaker, and is turned on and off when exposed to a magnetic field – so anything that creates a magnetic field can affect the pacemaker.    For some patients this can be potentially dangerous while for thers is is quite safe.   Discuss with your cardiologist or pacemaker technician if these apply to you. 

Both pacemakers and defibrillators only function when needed, they constantly monitor the heart rhythm, and when it is satisfactory, they do nothing.    However the sensing mechanism in the pacemakers can be affected by a number of external stimulae which are detailed below.   Note there are different types of pacemakers, and it is important to discuss with your cardiologist, pacemaker technician and anaesthetist if they apply to yours.   Most modern pacemakers are hermetically shielded inside a tatanium or steel case which may also have an insulative coating which gives additional but not complete protection.


External factors which can affect pacemakers (and ICDs)

Surgery – Electrocautery is used during surgery to cut tissues and stop bleeding.  This can interfer with the pacemaker function and can cause some cardiac damage if the electrocautery tip is near the pacemaker.  Tell your anaesthetist and surgeon that you have a pacemaker and its details, and it is recommened that the electrocautery should be for brief periods only, the cardiac rhythm monitored, bipolar electrocautery should be used, and not in the region of the pacemaker.  The pacemaker should also be checked after surgery.

MRI scanners – The powerful MRI magnetic field will switch the pacemaker into the fixed rate – see above.   Titanium pacemakers should not be affected by the powerful magnetic field, but earlier ones could potentially be twisted by the magnetism.   Take your pacemaker details with you before the MRI and discuss with your cardiologist or radiologist if MRI is safe.  It is probably advisable to have the pacemaker checked after an MRI examination.

Radiotherapy – this can damage the pacemaker and its function if irradiation is too close to the unit.  It is essential that the treatment is discussed with your cardiologist and radiotherapist , that the pacemaker function is checked before therapy, carefully monitored during treatment and the pacemaker checked after treatment.

Lithotrypsy – used to shatter kidney stones.    These are usually a long way away from the pacemaker which should not be affected, but it is best to recheck pacemaker function after therapy.

Cellular phones –  It is possible for the electromagnetic field from the phone to affect a pacemaker and it is recommended that the phone be held at least 15 cm away from the pacemaker, both the chest unit and also the lead in the heart.   It is best used in the ear opposite to the pacemaker side, and also do not carry the phone in your breast pocket.

Induction stoves –  these work by creating time varying magnetic currents which heat up the ferromagnetic bottom of a cooking pot. It is possible for his to affect the pacemaker, but can be avoided if the pot is centrally placed over the heating unit, using a larger piot to cover the coil, and maintain a distance of at least 35 cm.   Do not lean over the stove, hold the pot with the right hand  and if a lot of stirring is required, get someone else to do it.

Dental equipment – ultrasound scalers and cleaners and some electrosurgical instrumets can affect the pacemaker and should only be used briefly.

Arc welding – these can generate magnetic frilds and pacemaker patients should stay clear of them.

Airport security and anti theft devices – these are usually columns placed at airports or the exits to shops.  Potentially these could temporaril;y affect the pacemaker, but only if you stop inside the field .  Walking smartly through them should impose no risk.   However if security use a hand held wand, tell them you have a pacemaker and not to hold it over the pacemaker any longer than is absolutely necessary   Note many airports can camoflage their detectors so dont spend more time than is necessary in the area.  Whole body scanners do not  affect the pacemaker.

Home appliances usually have very little risk, these include CB radios or amateur (“ham”) radios, Electric drills, Electric blankets, Electric shavers, Heating pads, Metal detectors for recreational use, Microwave ovens ,TV transmitters and remote control TV changers, MP3 players (but headphones should be kept at least 1.2 inches or 3 cm away from the device as they can contain magnets)

Other therapies

There are a number of other therapies which you might like to look at.  They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help.    They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner.    My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.

Nutritional supplements

I believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.