New Cell Phone and Smart Watch Models Can Interfere with Pacemakers and Defibrillators

After reports of smart phone and watch interference with implanted medical devices, investigators affiliated with the Center for Devices and Radiological Health (CDRH) at the US Food and Drug Administration conducted a study that supports the FDA recommendation that patients keep any consumer electronic devices that may create magnetic interference, including cell phones and smart watches, at least six inches away from implanted medical devices, in particular pacemakers and cardiac defibrillators. Their findings appear in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier.

“Ensuring the safety of our nation’s medical devices is a cornerstone of our consumer protection mission, especially as technology continues to advance,” explained lead investigator Seth J. Seidman, MS, Research Electrical Engineer and EMC Program Advisor with the CDRH. “As part of this work, the agency reviewed recently published articles describing the possibility that certain newer cell phones, smart watches and other consumer electronics with high field strength magnets may temporarily affect the normal operation of implanted electronic medical devices, such as pacemakers and implantable defibrillators. Based on our review, we decided to conduct our own testing to confirm and help inform appropriate recommendations for patients and consumers.”

Cardiac implanted electronic devices are intended to support heart rhythm disorders, such as slow or fast heart rates. Implantable pacemakers and cardioverter defibrillators (ICDs) include a “magnet mode” designed to be used when a patient is undergoing a procedure where electromagnetic interference is possible, or when suspension of the device is necessary for medical treatment. However, this feature can also be triggered accidentally from strong magnetic fields greater than 10G, which can change how the device works and could result in serious harm to the patient.

Historically, magnets strong enough to trigger this magnet mode were very large and identifiable, such as stereo speakers or electronic motors in cordless tools. With the advent of small rare-earth magnets, however, strong magnetic fields can be found in headphones, door locks, or small phone speakers.

The investigators tested the magnetic field output of all iPhone 12 and Apple Watch 6 models at varying distances from the devices. They found that all the devices have static magnetic fields significantly greater than 10G in close proximity, high enough to place implanted cardiac devices into magnet mode. However, when a separation distance of six inches or more is maintained, the phones and watches will not trigger magnet mode.

“Because of these results, we are taking steps to provide information for patients and healthcare providers to ensure they are aware of potential risks and can take simple proactive and preventive measures like keeping consumer electronics, such as certain cell phones and smart watches, six inches away from implanted medical devices and not carrying consumer electronics in a pocket over the medical device,” advised Mr. Seidman.

“We believe the risk to patients is low and the agency is not aware of any adverse events associated with this issue at this time. However, the number of consumer electronics with strong magnets is expected to increase over time. Therefore, we recommend people with implanted medical devices talk with their healthcare providers to ensure they understand this potential risk and the proper techniques for safe use. The FDA will continue to monitor the effects of consumer electronics on the safe operation of medical devices,” noted Mr. Seidman.

Source: Elsevier

Kids Who Snore Could be at Risk for Blood Pressure, Heart Problems

Obstructive sleep apnea, a type of sleep disorder characterized by disrupted breathing, may be linked to changes in blood pressure and heart structure in children and adolescents, according to a new scientific statement.

The American Heart Association report urges parents and health care providers to consider testing for children who exhibit symptoms, have obesity or have enlarged tonsils, which puts them at higher risk.

Estimates show up to 6% of all children and adolescents have obstructive sleep apnea, according to the statement published Wednesday in the Journal of the American Heart Association.

Symptoms of obstructive sleep apnea include habitual snoring, gasps, snorting or labored breathing while sleeping, daytime sleepiness, sleeping while seated with a distended neck, a headache upon waking and signs of an upper airway obstruction. The condition often occurs in children with obesity. About 30%-60% of children who meet the criteria for obesity – having a body mass index in the 95th percentile or higher – also have sleep apnea.

“We need to increase awareness about how the rising prevalence of obesity may be impacting sleep quality in kids and recognize sleep-disordered breathing as something that could contribute to risks for hypertension and later cardiovascular disease,” statement writing group chair Dr. Carissa M. Baker-Smith said in a news release. Baker-Smith is director of pediatric preventive cardiology at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware. She also is associate professor of pediatric cardiology at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia.

Obstructive sleep apnea is associated with cardiovascular disease in adults but less is known about how the condition affects the immediate and long-term heart health of children and adolescents. A review of the most current research included in the statement found evidence it can impact emotional health, as well as the immune, metabolic and cardiovascular systems in children and adolescents.

Obstructive sleep apnea risk factors vary with age. In addition to obesity, they include upper and lower airway disease; allergic rhinitis, inflammation and swelling in the nose’s mucous membrane; low muscle tone; enlarged tonsils and adenoids; craniofacial malformations; and neuromuscular disorders. Sickle cell disease, an inherited blood disorder, also is a risk factor.

Children born prematurely, who have delayed development of respiratory control and smaller upper airways, also may be at higher risk for sleep-disordered breathing. However, this risk gets smaller as children grow.

The statement supports recommendations from the American Academy of Otolaryngology and Head and Neck Surgery that say sleep studies, or polysomnographies, are the best test for diagnosing sleep-disordered breathing. Prior to getting a tonsillectomy, children should take this test if they have conditions that raise their risk for breathing complications during surgery. These include obesity, Down syndrome, craniofacial abnormalities such as a cleft palate, and disorders such as muscular dystrophy or sickle cell disease.

Children and adolescents with obstructive sleep apnea also may have trouble regulating blood pressure. While blood pressure typically dips during sleep, children with this condition see smaller dips than those without it. Adults whose blood pressure fails to dip during sleep have a higher risk for cardiovascular events. Because of this, the statement calls for 24-hour blood pressure monitoring to check levels in children with sleep apnea.

Even mild cases of sleep apnea – defined as just two pauses in breathing per hour – are associated with a higher risk for metabolic syndrome in children. Metabolic syndrome is a cluster of factors including high insulin and triglyceride levels, elevated blood pressure and low levels of high-density lipoprotein, or HDL, the “good” cholesterol. Continuous positive airway pressure, or CPAP, is a treatment for sleep apnea that delivers pressurized air through a mask that can lower triglyceride and improve HDL levels.

Long-term, severe sleep apnea also may put children at higher risk for pulmonary hypertension, when pressure in the blood vessels from the heart to the lungs is too high. The statement committee recommends that future research on how sleep apnea affects children’s risk for heart problems incorporates 24-hour blood pressure monitoring and measures of metabolic syndrome factors.

Source: American Heart Association

Healthy Hearts and Brains Get Their Start in Childhood

Laura Williamson wrote . . . . . . . . .

High blood pressure, high cholesterol and other risk factors for poor heart and brain health are problems people typically don’t think about until they hit midlife.

A growing body of research suggests they should start sooner – decades sooner.

“These factors that can be modified through lifestyle choices are already very important in childhood,” said Dr. Juuso Hakala, a PhD student at the Research Centre of Applied and Prevention Cardiovascular Medicine at the University of Turku in Finland. Hakala was lead author an analysis of data from the Cardiovascular Risk in Young Finns study, which tracked 3,596 children and adolescents for three decades. In 2011, researchers gave 2,000 participants a computerized cognitive function test and found managing weight, cholesterol and blood pressure early in life could impact cognitive function in adulthood.

Children with consistently high blood pressure and cholesterol levels had poorer memory and learning abilities by midlife than those with better heart health measures, the study found. Those who were obese throughout life were less able to process information or maintain attention as they got older. By the time they reached their 40s, those who had all three heart risk factors performed poorest on all measures of brain health.

The link between heart and brain health is well established. Good blood flow keeps both organs working properly. Research has shown conditions and behaviors that damage blood vessels, such as high blood pressure and cholesterol, put both heart and brain at risk and can lead to heart attacks, strokes and dementia.

With the increase in childhood obesity in recent decades and growing evidence that poor heart health begins to develop as early as childhood, health experts are increasingly focused on the importance of setting the stage early in life to prevent harm later.

“Lifestyle needs to change at a much earlier age,” said Dr. Mitchell Elkind, immediate past president of the American Heart Association and a professor of neurology and epidemiology at Columbia University Irving Medical Center in New York City. “We need to get the message out there to young people, starting with children. We know the behaviors you adopt in childhood often are the ones that persist throughout life.”

Federal guidelines recommend children and teens ages 6 to 17 get at least one hour of moderate to vigorous physical activity each day, with that hour including more intense activities at least three times a week to keep muscles and bones strong. They also suggest it’s important to limit sedentary time in front of a screen.

“It’s not just what you do, but also what you don’t do,” said Gabriel Shaibi, a professor at Arizona State University’s Edson College of Nursing and Health Innovation and director of its Center for Health Promotion and Disease Prevention in Phoenix.

Regular physical activity – independent of weight – “has been shown to have effects on cognitive function, academic achievement and outcomes in general,” he said.

And, while studies show children who are obese have higher mortality and greater heart risks later in life, the added risk disappears if they lose the extra weight when they grow up, Shaibi said. “So do we focus on weight loss, or instead do we focus on improving health by meeting physical activity guidelines and avoiding too much sedentary screen time?”

Many kids don’t get enough physical activity in their daily lives to reap heart and brain health benefits. Just getting them up and moving, Shaibi said, might be a better strategy than focusing on weight loss, which can be very difficult to achieve.

“By shifting the focus away from weight and into behaviors, we have a better chance of improving outcomes in the interim that are associated with long-term benefits,” he said.

That doesn’t mean people who have been inactive most of their lives can’t take steps now to improve heart and brain health.

“Of course, if you have lifelong good habits, it’s better,” Hakala said. “But it’s never too late to start.”

Source: American Heart Association

Exercise Boosts Survival for People With Implanted Defibrillators

Just small amounts of exercise can benefit people with implanted heart defibrillators, new research shows.

An implantable cardioverter defibrillator (ICD) is a battery-powered device placed under the skin to detect abnormal heart rhythms and deliver an electric shock to restore a normal heartbeat.

The new study found that even slight increases in physical activity reduced the risk of hospitalization and early death after patients got an ICD. And that was true even if their fitness boost wasn’t from a formal rehabilitation program, according to findings published in the journal Circulation: Cardiovascular Quality and Outcomes.

“Cardiac rehabilitation programs offer patients a safe environment to increase physical activity after ICD implantation,” said study author Dr. Brett Atwater, director of electrophysiology at the Inova Heart and Vascular Institute in Fairfax, Va.

“Evidence has also shown cardiac rehab lessens the risk of additional hospitalization and death, but cardiac rehabilitation programs are underutilized, especially among women, the elderly, people from diverse racial and ethnic groups and those living in rural areas,” he said in a journal news release.

Atwater and his team examined data on nearly 42,000 Medicare patients (average age: 75) who got ICDs between 2014 and 2016.

Of those, 3% took part in a heart rehab program. During rehab, their physical activity rose by nearly 10 minutes a daily, compared to a minute-a-day drop off among patients not in rehab.

Those in a rehab program were 24% less likely to die within three years of getting their ICD than patients who were not in rehab.

The study also linked every 10 minutes of increased daily activity to a 1.1% reduction in death from all causes during that time span — whether patients were in a formal rehab program or not.

“Our study examined whether physical activity outside of a formal cardiac rehabilitation program could yield similar benefits, and we found it did,” Atwater said. “This suggests that additional options like home-based cardiac rehabilitation might help more patients realize the health benefits of increased physical activity.”

Source: HealthDay

5 Ways to Keep Your Heart Safe in Extreme Heat

With many areas of the country facing triple digit temperatures and summer heat and humidity elsewhere, the American Heart Association, a global force for longer, healthier lives for all, is urging people to take extra steps to protect their hearts. Precautions are especially important for older adults and individuals with high blood pressure, obesity or a history of heart disease and stroke.

Temperatures over 100 or even temperatures in the 80s with high humidity can cause a dangerous heat index that can be hard on the heart. Recent research published in Circulation, the flagship journal of the American Heart Association, found that when temperatures reach extremes of an average daily temperature of 109 degrees Fahrenheit, the number of deaths from cardiovascular disease may double or triple. Another study, featured at the American Stroke Association’s International Stroke Conference, suggests that the more temperatures fluctuate during the summer, the more severe strokes may become.

In hot weather, the body tries to cool itself by shifting blood from major organs to underneath the skin. This shift causes the heart to pump more blood, putting it under significantly more stress.

“If you’re a heart patient, older than 50 or overweight, the American Heart Association suggests you take special precautions in the heat to protect your heart,” said Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, the American Heart Association’s new volunteer president and chair of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.

“Some heart medications like angiotensin receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, beta blockers, calcium channel blockers and diuretics, which affect blood pressure responses or deplete the body of sodium, can exaggerate the body’s response to heat and cause you to feel ill in extreme heat,” added Lloyd-Jones, whose term as president began July 1. “But don’t stop taking your prescriptions. Learn how to keep cool and talk to your doctor about any concerns.”

Even if you aren’t taking medications for a heart condition, it is important to take precautions in the heat. While infants and the elderly are more vulnerable to problems from heat, extreme temperatures can cause health issues for anyone.

“Staying hydrated is key. It is easy to get dehydrated even if you don’t think you’re thirsty,” Lloyd-Jones said. “Drink water before, during and after going outside in hot weather. Don’t wait until you feel thirsty. And the best way to know if you are getting enough fluid is to monitor your urine output and make sure the urine color is pale, not dark or concentrated.”

Dehydration causes the heart to work harder, putting it at risk. Hydration helps the heart more easily pump blood through the blood vessels to the muscles. And it helps the muscles work efficiently.

The American Heart Association suggests that everyone follows these top 5 hot weather precautions:

  • Watch the clock: It’s best to avoid the outdoors in the early afternoon (about noon to 3 p.m.) because the sun is usually at its strongest, putting you at higher risk for heat-related illnesses.
  • Dress for the heat: Wear lightweight, light-colored clothing in breathable fabrics such as cotton, or a newer fabric that repels sweat. Add a hat and sunglasses. Before you get started, apply a water-resistant sunscreen with at least SPF 15, and reapply it every two hours.
  • Drink up: Stay hydrated by drinking a few cups of water before, during and after going outside or exercising. Avoid caffeinated or alcoholic beverages.
  • Take regular breaks: Find some shade or a cool place, stop for a few minutes, hydrate and start again
  • Follow the doctor’s orders: Continue to take all medications as prescribed.

It’s important to know the signs and symptoms when you may be experiencing too much heat.

Symptoms of heat exhaustion:

  • headaches
  • heavy sweating
  • cold, moist skin, chills
  • dizziness or fainting (syncope)
  • a weak and rapid pulse
  • muscle cramps
  • fast, shallow breathing
  • nausea, vomiting or both

If you experience these symptoms, move to a cooler place, stop exercising and cool down immediately by dousing yourself with cold water and re-hydrating. You may need to seek medical attention.

Symptoms of heat stroke:

  • warm, dry skin with no sweating
  • strong and rapid pulse
  • confusion and/or unconsciousness
  • high fever
  • throbbing headaches
  • nausea, vomiting or both

If you experience these symptoms, seek medical attention right away. Heat stroke is not the same as a stroke. Stroke happens when a blood vessel to the brain either bursts or is blocked by a clot, causing a decrease in oxygen flow to the brain.

Source : American Heart Association