The Effects of Electronic Article Surveillance Systems on Permanent Cardiac Pacemakers: An In Vitro Study

Five Siemens Pacesetter cardiac pacemakers (PM) were subjected to in vitro testing with six different electronic article surveillance (EAS) devices. The PMs consisted of polarity programmable, dedicated bipolar, and dedicated unipolar types. EAS equipment included UHF, RF, Magnetic, and Magnetoacoustic (MA) devices from two manufacturers. Prior to testing, each PM was interrogated and normal operation confirmed. Each PM was attached to a heart simulator via an eight foot cable and then subjected to testing within the EAS field. The PMs were passed through the field in two axes, positioned stationary within the field, and, worst case (WC), placed directly against the transmitter. During testing the ECG was observed and PM behavior recorded. In one PM (Synchrony III^R), Event Records, and Event Histograms were utilized. At the conclusion of testing with each EAS device the PM was evaluated for normal operation. Results: No PM was reprogrammed by the EAS devices. UHF produced no effect on the PMs. RF produced noise response in one unipolar PM while in the WC position. High frequency and multifrequency magnetic units produced positive results only in the WC position. Unipolar PMs were affected more often than bipolar. MA and older magnetic EAS units produced more positive responses than newer lower power devices. One incident of close coupled (400 msec) ventricular pacing was seen with the MA EAS unit. Conclusions: UHF, RF, high frequency, and dual frequency magnetic FAS produced few effects during in vitro testing. Except with the MA and low frequency magnetic devices, positive results occurred only in WC conditions. Additional in vitro and in vivo testing is required to evaluate the interaction between PM patients and EAS devices. Careful evaluation of MA EAS systems with a wide variety of PMs is indicated to rule out RF induction through the lead system of the PM.