Would this happen with any sufficiently powerful magnet? Also, does anybody know why the magnets would turn off a pacemaker? Pacemakers try very hard to filter out EMI.
Yes, the article mentions the defibrillators are meant to the turned off by magnets. The iPad magnet just happens to be powerful enough to trigger the off switch.
If the pacemaker develops a fault, or you're seeing your doctor and they want to see your natural rhythm, or several other situations where you want to go 'natural' for a while. There's a leaf switch inside - it's a design feature, not a fault.
You do need a decent magnetic field next to the pacemaker - having it near a fridge magnet while you open the fridge looking to sneak a snack isn't going to do it.
I used to work as a neuro tech, and we would occasionally reprogram vagus nerve stimulators (sort of a defibrillator for the vagus nerve). Every few minutes it would send a charge up the vagus nerve, which could scramble rhythms that might be developing into a seizure. You could dell when it was firing if the person was talking - every few minutes, their voice would go funny for a couple of seconds as the vocal chords are innervated by the vagus. It wasn't the most pleasant experience, but you did get used to it, and it was better than the general level of seizures you'd have to have to get one implanted in the first place.
It's common practice in peer-reviewed cardiology publications. Some titles are clearly constructed around the acronym (I guess the cool kids call that a "backronym"). We even cite the abbreviated studies (like PIOPED) in our medical notes, though I'll admit I don't enjoy doing it.
I specifically avoid speaking "like a doctor" around my kids; it induces a cringe like no other when I see teenagers trying to speak like an experienced MD.
That said, this Gianna girl seems well-composed, poetry and all.
I wonder if the magsafe (magdeadly?) socket has the same issue; it is probably weaker overall since you can hold an ipad up by its cover but can't come close to holding a macbook air by its plug.
> "Walter Chien, a cardiac electrophysiologist, helped his daughter coordinate the patient testing."
Maybe this is why she didn't win first place? At any rate, if this finding holds up, this is a serious problem.
Edit: "the project was beat out for the top spot by work on electromagnetics and on the effect of punctuation mark placement in keyboards on carpal tunnel syndrome."
So I guess she's just up against really stiff competition.
The "she didn't win first place" is hardly a surprise when you consider the absurd subjectivity of "science fairs." (ie. different judges for each project, different criteria)
Assuming that she was competing for the Intel Science and Engineering Fair (ISEF), as a former judge, I can say that her project has a major red flag. One of the disqualification criteria applied to projects is to examine if an Institutional Review Board (IRB) properly vetted her project and approved experimention on human subjects. From my perspective, if her paperwork was anything less than pristine, signed, and notarized, I could not imagine a judging committee electing it to first place.
Bloomberg, in typical sensationalist fashion, calls this a "dangerous iPad2 flaw" when defibrillator patients are already educated about the risk of magnets and Apple's manual informs users of the magnets and warns against this exact problem.
They continue (in the video) and lump pacemakers into the warning even though their own article specifies that pacemakers were unaffected: "The iPad2 didn’t interfere with four pacemakers or a loop-recorder, which were also tested."
tl;dr - 14 year old's dad does her science fair project for her and doesn't win. Nobody learns anything and the news gets it all wrong.
It was her idea, she concocted the theory, investigation and reported the results. Insofar as she didn't do part of the full experiment, no teenager should be allowed to carry out casual experiments involving shutting off life-support equipment on heart patients - duh, let an adult handle that bit. That she didn't win doesn't mean anything more than the winners were better projects, drama aside.
People DID learn something. Awareness is spreading about the issues of proliferation of magnets strong enough to cause false inputs to implanted medical devices.
The only thing the news got wrong was the subtle jab at Apple, rather than a more neutral reference to the many magnet-containing products which have similar odds of the same problem.
> It was her idea, she concocted the theory, investigation and reported the results.
As far as Bloomberg reports. Her father is hinted as being a heart surgeon ("given her father's specialty") but it's never explicitly pointed out in the article.
She's obviously extremely intelligent—and I have no qualms with a 14 yo getting some hints from their parents for a project idea—but the article seems designed to sensationalise an issue that has long existed.
See also [1] for a case caused by the hard drive of a laptop.
Fundamentally, this is a consequence of the decision of manufacturers such as Medtronic to use a magnetic field to temporarily disable implantable cardioverters/defibrillators. Note that magnetic fields do different things for ICDs produced by different manufacturers.
Having a pacemaker, I've been quietly paranoid about any magnets coming anywhere close to it. That includes keeping the iPad away from the area, both because of magnets and the radio transmitter.
One of the first warnings I got about having one was to not dangle earbuds around my neck where they would hang in front of my left shoulder. Other warnings about keeping distance from generators, magnets, shoulder-pressed cell phones, store theft-deterrent sensors, and even chainsaws (cardiologist & I got a kick out of wondering which would kill me first: the alternator's fields knocking out the pacer, or my passed-out fall into the still-spinning blade). MRIs...just don't even go there.
The problem with magnets is more complex than perhaps obvious. There's bad input, and then there's damage. What the girl is referring to is quite legitimate: defibrillators and pacemakers typically allow proximity of a magnet as a "master override" function. When I suffered an unrelated instance of atrial flutter (heart decided to run at 350bpm, pacemaker hit the brakes at 150...for 12 hours), the ER doc not having a diagnostic system handy forced the pacemaker to reduce to a much more humane rate by placing a good-sized magnet over the pacemaker; this allowed a more relaxed 2-hour wait for a technician to arrive and better diagnose & manage the problem (the subsequent drive-thru heart surgery is another story). She's raising awareness that sometimes this "master override" function can be induced improperly and even unknowingly, leaving the patient in a high-risk condition without knowing until periodic diagnostics or medical failure. A related issue she may tangentially raise awareness of is outright damage, with induced currents overstimulating the patient or frying the electronics (see aforementioned chainsaw issue).
She's raising a good issue. With the proliferation of tiny super-magnets, an enduring technical problem must be revisited: how to provide a low/no-impact way to essentially "hit the reset button" on an implanted medical device when there is no visible/external contacts? Not long ago, using a strong magnet to activate a magnetic switch was a sensible solution. Today, stronger magnetic fields are coming closer more often, risking activating a "safe/master mode", and there's not much way to alert anyone to the condition.
To address a few other points: Yes, any small but strong magnets like the magsafe plug are a possible problem. It's not an EMI problem so much as false input to a magnetic sensor. Defibrillators and pacemakers face the same basic problem, but the former moreso because the "master override" function needed is a function shutdown (need a way to turn it off and keep it off), while the latter responds in a more benign manner.
Glad to hear someone raising awareness of the issue. Amused that it's a child figuring it out and publicizing it. Thanks, kid!
One comment, the magnet for magsafe power supplies is actually in the laptop, not the plug.
Have you heard about people implanting a tiny magnet in their pinky finger? I think they've been mentioned on HN before... could give you insight about magnetic fields around you (assuming it was weak enough not to be a cause for concern itself).
Glad to know that magnet isn't where I thought it is.
Yeah, I've heard of the magnetic finger modification. I promptly was concerned about it, not quite sure why but favor caution; sure wouldn't want one given the possible consequences. Since earbud magnets are enough to warrant concern, I'll avoid what is likely more powerful.
Woolrich has a line of shirts I want which feature magnetic "button". Can't convince myself they wouldn't be a problem.
This seems like a terrible design decision. I always thought magnets were interfering with the function of the pacemaker, but to use them as a crude communication protocol is rather.. disconcerting.
If you needed to turn off the implant right here and now, how are you going to do it? Carve into their chest and flick a switch? Magnets are common and can be found in most locations.
That's it. Disconcerting, yes, but no better option - and I lived thru "needed to reset the implant right here and now" (150 BPM for 12 hours sucks; didn't want another 2+ waiting for a better protocol to arrive).
I survived the other end of the scale. I managed to live with a heart rate between 25 and 45 bpm for 7 hours. My aorta was 6.5cm in diameter before they found the ascending dissection, which started about 1mm from the aortic root, and terminates in my left iliac.
I had a pacer wire for about 5 days post-surgery. Shocked me once. That sucked.
Before the implant I had an external pacemaker for 3 days. No shocks, but someone brought a bunch of med students by and started fiddling with the BPM knob for no good reason. "Please stop that." And be very, very careful with that wire.
Post implant, setup process caused several convulsions. Harmless, but gave me a giggling fit. Thanks to one wire too close to my diaphragm I couldn't sleep on my left side (compressed them together) for two years until they figured out how to reprogram it to stop making me twitch each beat.
Diagnostics is always amusing when they drop the heart rate to 40, and do it as if I won't notice.
31 comments
[ 3.6 ms ] story [ 77.4 ms ] threadEdit: Implanted defibrillators, not pacemakers
You do need a decent magnetic field next to the pacemaker - having it near a fridge magnet while you open the fridge looking to sneak a snack isn't going to do it.
I used to work as a neuro tech, and we would occasionally reprogram vagus nerve stimulators (sort of a defibrillator for the vagus nerve). Every few minutes it would send a charge up the vagus nerve, which could scramble rhythms that might be developing into a seizure. You could dell when it was firing if the person was talking - every few minutes, their voice would go funny for a couple of seconds as the vocal chords are innervated by the vagus. It wasn't the most pleasant experience, but you did get used to it, and it was better than the general level of seizures you'd have to have to get one implanted in the first place.
I specifically avoid speaking "like a doctor" around my kids; it induces a cringe like no other when I see teenagers trying to speak like an experienced MD.
That said, this Gianna girl seems well-composed, poetry and all.
"EMIT: Does iPad Use in Patients with Implantable Cardiac Rhythm Devices Cause Electromagnetic Interference?"
(EMIT looks intended to be an acronym, but what do the letters stand for?)
As I commented above, this is usual practice for cardiology publications. And her dad is a cardiology subspecialist.
Maybe this is why she didn't win first place? At any rate, if this finding holds up, this is a serious problem.
Edit: "the project was beat out for the top spot by work on electromagnetics and on the effect of punctuation mark placement in keyboards on carpal tunnel syndrome."
So I guess she's just up against really stiff competition.
They continue (in the video) and lump pacemakers into the warning even though their own article specifies that pacemakers were unaffected: "The iPad2 didn’t interfere with four pacemakers or a loop-recorder, which were also tested."
tl;dr - 14 year old's dad does her science fair project for her and doesn't win. Nobody learns anything and the news gets it all wrong.
It was her idea, she concocted the theory, investigation and reported the results. Insofar as she didn't do part of the full experiment, no teenager should be allowed to carry out casual experiments involving shutting off life-support equipment on heart patients - duh, let an adult handle that bit. That she didn't win doesn't mean anything more than the winners were better projects, drama aside.
People DID learn something. Awareness is spreading about the issues of proliferation of magnets strong enough to cause false inputs to implanted medical devices.
The only thing the news got wrong was the subtle jab at Apple, rather than a more neutral reference to the many magnet-containing products which have similar odds of the same problem.
As far as Bloomberg reports. Her father is hinted as being a heart surgeon ("given her father's specialty") but it's never explicitly pointed out in the article.
She's obviously extremely intelligent—and I have no qualms with a 14 yo getting some hints from their parents for a project idea—but the article seems designed to sensationalise an issue that has long existed.
"Apple story == page views".
You're right, of course. I was being overly cynical. These types of "news" stories just get my hackles up.
Fundamentally, this is a consequence of the decision of manufacturers such as Medtronic to use a magnetic field to temporarily disable implantable cardioverters/defibrillators. Note that magnetic fields do different things for ICDs produced by different manufacturers.
[1] = https://www.ncbi.nlm.nih.gov/pubmed/22353166
[2] = http://www.medscape.com/viewarticle/585151_2
One of the first warnings I got about having one was to not dangle earbuds around my neck where they would hang in front of my left shoulder. Other warnings about keeping distance from generators, magnets, shoulder-pressed cell phones, store theft-deterrent sensors, and even chainsaws (cardiologist & I got a kick out of wondering which would kill me first: the alternator's fields knocking out the pacer, or my passed-out fall into the still-spinning blade). MRIs...just don't even go there.
The problem with magnets is more complex than perhaps obvious. There's bad input, and then there's damage. What the girl is referring to is quite legitimate: defibrillators and pacemakers typically allow proximity of a magnet as a "master override" function. When I suffered an unrelated instance of atrial flutter (heart decided to run at 350bpm, pacemaker hit the brakes at 150...for 12 hours), the ER doc not having a diagnostic system handy forced the pacemaker to reduce to a much more humane rate by placing a good-sized magnet over the pacemaker; this allowed a more relaxed 2-hour wait for a technician to arrive and better diagnose & manage the problem (the subsequent drive-thru heart surgery is another story). She's raising awareness that sometimes this "master override" function can be induced improperly and even unknowingly, leaving the patient in a high-risk condition without knowing until periodic diagnostics or medical failure. A related issue she may tangentially raise awareness of is outright damage, with induced currents overstimulating the patient or frying the electronics (see aforementioned chainsaw issue).
She's raising a good issue. With the proliferation of tiny super-magnets, an enduring technical problem must be revisited: how to provide a low/no-impact way to essentially "hit the reset button" on an implanted medical device when there is no visible/external contacts? Not long ago, using a strong magnet to activate a magnetic switch was a sensible solution. Today, stronger magnetic fields are coming closer more often, risking activating a "safe/master mode", and there's not much way to alert anyone to the condition.
To address a few other points: Yes, any small but strong magnets like the magsafe plug are a possible problem. It's not an EMI problem so much as false input to a magnetic sensor. Defibrillators and pacemakers face the same basic problem, but the former moreso because the "master override" function needed is a function shutdown (need a way to turn it off and keep it off), while the latter responds in a more benign manner.
Glad to hear someone raising awareness of the issue. Amused that it's a child figuring it out and publicizing it. Thanks, kid!
One comment, the magnet for magsafe power supplies is actually in the laptop, not the plug.
Have you heard about people implanting a tiny magnet in their pinky finger? I think they've been mentioned on HN before... could give you insight about magnetic fields around you (assuming it was weak enough not to be a cause for concern itself).
EDIT: past story on the implants.
http://www.iamdann.com/2012/03/21/my-magnet-implant-body-mod...
https://news.ycombinator.com/item?id=3734130
Yeah, I've heard of the magnetic finger modification. I promptly was concerned about it, not quite sure why but favor caution; sure wouldn't want one given the possible consequences. Since earbud magnets are enough to warrant concern, I'll avoid what is likely more powerful.
Woolrich has a line of shirts I want which feature magnetic "button". Can't convince myself they wouldn't be a problem.
I had a pacer wire for about 5 days post-surgery. Shocked me once. That sucked.
Post implant, setup process caused several convulsions. Harmless, but gave me a giggling fit. Thanks to one wire too close to my diaphragm I couldn't sleep on my left side (compressed them together) for two years until they figured out how to reprogram it to stop making me twitch each beat.
Diagnostics is always amusing when they drop the heart rate to 40, and do it as if I won't notice.