From the Guidelines
Pacemakers should never be exposed to strong magnetic fields, including those generated by certain batteries, to minimize the risk of electromagnetic interference and ensure patient safety. Patients with pacemakers should avoid placing strong magnets, such as those found in headphones, speakers, and some battery-powered devices with magnetic components, directly over their implanted device. Standard household batteries (AA, AAA, etc.) pose no risk to pacemakers during normal handling and use, as stated in the guidelines for cardiac pacing and cardiac resynchronization therapy 1. However, neodymium or rare earth magnets, which may be found in some specialized battery applications, should be kept at least 6 inches (15 cm) away from the pacemaker site. This precaution is necessary because strong magnetic fields can activate a pacemaker's "magnet mode," which forces the device to pace at a fixed rate rather than responding to the heart's natural rhythm, as noted in the 2009 ACCF/AHA focused update on perioperative beta blockade 1.
Some key considerations for patients with pacemakers include:
- Avoiding strong magnetic fields, including those generated by certain batteries
- Keeping neodymium or rare earth magnets at least 6 inches (15 cm) away from the pacemaker site
- Brief exposure to battery-powered devices near the chest, such as electric razors or toothbrushes, is generally safe, but these items should not be stored directly over the pacemaker
- The electromagnetic interference risk comes from the magnetic field strength rather than the battery itself, so the primary concern is with devices containing magnets rather than standard batteries, as highlighted in the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery 1.
It is essential to note that the risk of electromagnetic interference is related to the amount of current generated in the vicinity of the pacemaker or ICD device, and high current is generated if the cautery device is close to the pacemaker, particularly if the current path of the cautery lies along the axis of the pacemaker or ICD lead, as discussed in the guidelines 1. Therefore, patients with pacemakers should take precautions to minimize exposure to strong magnetic fields and electromagnetic interference to ensure their safety and the proper functioning of their device.
From the Research
Contraindications between Pacemaker and Batteries
- There are no direct contraindications between pacemakers and batteries mentioned in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the potential risks and interactions between pacemakers and magnetic fields, such as those used in MRI scans 2, 3, 5.
- The use of MRI in patients with pacemakers is generally contraindicated, but some pacemakers are designed to be MRI-conditional, meaning they can be safely used in an MRI environment under certain conditions 2, 3, 5.
- The studies also discuss the importance of proper programming and reprogramming of pacemakers before and after MRI scans to minimize the risk of adverse events 3, 5.
- In terms of battery life, one study mentions a case where a pacemaker with less than 1 month of battery life reset to a backup mode during an MRI scan and could not be reprogrammed, requiring replacement 3.
Pacemaker and MRI Interactions
- The studies highlight the potential risks of MRI scans in patients with pacemakers, including device reset, changes in device parameters, and induced arrhythmias 3, 5.
- However, the studies also show that with proper precautions and protocols, MRI scans can be safely performed in patients with pacemakers, including those with non-MRI-conditional devices 3, 5.
- The use of frequency-scout and spoiled gradient echo sequences can help reduce susceptibility artifacts and improve image quality in cardiac MRI scans of patients with pacemakers 6.