Could Your E-Cig Disrupt Your Pacemaker?
The magnets in vaping devices might be able to wreak havoc on heart pacemakers and defibrillators, a new case report suggests.
By placing a Juul in his shirt pocket, a heart patient caused his implanted pacemaker and defibrillator to malfunction, his health care providers said.
"To our knowledge, this is the first time it's been reported," said report author Julie Shea, nurse practitioner at the Cardiovascular Arrhythmia Service at Brigham and Women's Hospital in Boston.
The 48-year-old male patient had a history of irregular heartbeats, or arrhythmia. A magnet in the e-cigarette kept his implanted cardioverter-defibrillator (ICD) from detecting and correcting episodes of arrhythmia, Shea said.
Fortunately, the man experienced no deadly episodes of arrhythmia before the problem was discovered and resolved, his doctors said.
Heart patients are warned to keep devices or objects that contain magnets or create a magnetic field away from their implanted pacemakers and defibrillators, Shea said. These include power tools, bank cards and name tags with magnetic strips, and cellphones. "Never store them in a shirt or jacket pocket," she said.
But a warning about vaping devices has not been made until now, Shea said.
The U.S. Food and Drug Administration says research doesn't indicate cellphones pose a significant risk to pacemaker operation, but recommends not storing it in a pocket directly over the pacemaker. The American Heart Association gives similar advice, suggesting cellphones and devices containing magnets be kept 6 inches away from pacemakers and defibrillators.
Shea and co-author Dr. Usha Tedrow, director of the Clinical Cardiac Electrophysiology Program at the Cardiovascular Arrhythmia Service at Brigham and Women's, were first tipped off to the problem when the patient told them his combination pacemaker/ICD had emitted a warning tone several times. However, remote monitoring showed his heart device was working normally. He also complained of no ill symptoms and said he hadn't had any magnetic devices near his chest.
But when they checked with the devices' manufacturer for further information, data showed magnetic interaction had occurred at four times when the man had heard the tone.
"I actually saw that device" when the patient visited the office, Shea said. "I asked him, 'What is that in your pocket?'"
The man then said the Juul had been in his chest pocket when his cardiac device had sounded the tone.
The findings were published March 16 in the journal HeartRhythm Case Reports.
The case study is a warning, Shea said, but the authors cannot extend it to all brands and models of vaping devices, as they only studied the Juul.
"Our intent is educational for providers and patients," she noted. "We want our colleagues to be aware."
Tedrow said heart patients who use Juuls could continue to use them "with adequate education."
According to Juul Labs' website, a Juul uses magnets to secure it to its USB charging dock. The company suggests keeping Juuls away from items with magnetic strips, such as credit cards, and cautions that the magnets may trigger a laptop to switch into sleep mode when using a computer's USB port to charge. The website also says its products meet international safety standards for electromagnetic compatibility. The company did not respond to requests for comment.
Dr. Dhanunjaya Lakkireddy, executive medical director of electrophysiology at the Kansas City Heart Rhythm Institute, said e-cigarettes should not be kept in chest pockets. He said older pacemakers and combination pacemaker/ICDs would be more vulnerable to magnets in vaping devices, as newer models are now shielded.
Still, Lakkireddy, who wasn't part of the study, cautioned that if a Juul's magnets can cause a laptop to go into sleep mode, they might well cause a pacemaker/ICD to malfunction.
"The FDA needs to go back and look at these," said Lakkireddy.
To learn more about keeping pacemakers and ICDs safe from magnetic fields, go to the American Heart Association.
SOURCES: Julie Shea, M.S., R.N.C.S., nurse practitioner, Cardiovascular Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, Boston; Usha Tedrow, M.D., M.P.H., cardiologist, and associate professor, Harvard Medical School, and director, Clinical Cardiac Electrophysiology Program, Cardiovascular Arrhythmia Service, Brigham and Women's Hospital and Harvard Medical School, Boston; Dhanunjaya Lakkireddy, M.B.B.S., chair, electrophysiology section and leadership council, American College of Cardiology, and executive medical director, electrophysiology, Kansas City Heart Rhythm Institute; March 16, 2020, HeartRhythm Case Reports