Electromagnetic interference from automobile passive keyless entry in cardiovascular implantable electronic devices

ABSTRACT

Introduction

The automobile passive keyless entry (PKE) system is a potential source of electromagnetic interference (EMI). We aim to determine the incidence and significance of EMI from automobile PKE system in cardiovascular implantable electronic device (CIED) patients.

Methods

This was a single-center cross-sectional study conducted at Maharaj Nakorn Chiang Mai hospital, Thailand. Patients with CIED were instructed to lock and unlock two automobiles using the PKE system. Any EMI or arrhythmias were detected by CIED interrogation and single-lead electrocardiogram event recorder. We also used a spectrum analyzer to identify the automobiles working frequency bandwidth.

Results

There was a total of 102 CIED patients. Device types included 48.0% defibrillators, 37.3% permanent pacemakers, and 14.7% cardiac resynchronization therapy device. Both interrogated data from device and event monitor revealed no incidence of EMI during the PKE activation. We failed to identify the working frequency bandwidth of the two studied cars due to very low signal strength, thus blended in with the background noise.

Conclusions

Automobile PKE systems transmitted very low power signals. Therefore, under normal circumstances, CIED patients can use automobile PKE system safely without any EMI regardless of key fob positions in relation to the CIED pulse generator.

Trial Registration

The study was registered at ClinicalTrials.gov (https://clinicaltrials.gov), and the identification number is NCT03016390.

KEYWORDS:

• Keyless entry
• automobile
• electromagnetic interference
• cardiovascular implantable electronic device
• radiofrequency
• pacemaker

Article highlights

• There was no incidence of EMI and clinical arrhythmias from the automobile keyless entry RFID systems, regardless of key fob positions, device types, pacing dependency, and sensing configuration.

• Automobile keyless entry systems emitted very low power signals (−70 to −80 dBm) which blended in with the background noise.

• In summary, patients with CIED can use automobile keyless entry systems safely without restriction.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Acknowledgments

Authors express their appreciation to all on effort and contribution to the study from staffs in the Northern Cardiac Centers, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Author contributions

NP designed the study, collected data, performed statistical analysis, interpreted the data, and wrote the manuscript. TK collected spectrum analysis data. CP and SG collected and rechecked the data prior to the analysis. WW and AP designed the study and reviewed and revised the manuscript. TN performed data analysis and data interpretation and wrote and critically revised the manuscript. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was supported by grants from the Thailand Research Fund MRG5980178(N.P.) and the Faculty of Medicine Endowment Fund for medical research, Chiang Mai University, Thailand.The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.