“Window Effect” and Protective Measures of Exogenous Pulsed Electromagnetic Field on Implantable Cardiac Pacemaker

doi:10.16183/j.cnki.jsjtu.2021.326

Abstract

Abstract:

The electromagnetic interference (EMI) from pulsed electromagnetic field (PEMF) on pacemakers is unignorable in modern power grids and healthcare environments, but there is limited study on the interaction mechanisms and protective measures. In this paper, an in-vitro human chest model for pacemaker implantation is made by using pork tissues immersed in 0.9% sodium chloride solution. The effect of PEMFs generated by the switching actions of common electrical equipment and low-frequency medical equipment on pacemakers is simulated by using fast-front current sources. The pulse forming line theory is employed for analyzing the waveform compression of PEMFs in human thoracic cavity. Further, the parameterized bio-electromagnetic transient model of pacemaker in combination with biological tissues is established in finite element software. The results show that pacemaker malfunctions including pacing inhibition and P pulmonale occur under PEMF. The “Window effect” in subcutaneous pouch under PEMF is found by changing the winding of pacemaker leads in the pouch. Based on the research finding, a protective strategy by using composite materials to shield the window area is proposed. The theoretical feasibility of this protective measure is confirmed by simulation, where the intensity of pacemaker EMI could be reduced by 80 dB when the composite materials shielding is used. Finally, a safe distance is developed for pacemaker wearers in electrical and medical environments.

Key words: pacemaker, electromagnetic interference (EMI), pulsed electromagnetic field (PEMF), effect of strong electromagnetic field, electromagnetic interaction window

CLC Number:

TM154
TM72

LU Wu, DING Ranran, ZHAO Wenbin, HUANG Dong, WANG Zheming. “Window Effect” and Protective Measures of Exogenous Pulsed Electromagnetic Field on Implantable Cardiac Pacemaker[J]. Journal of Shanghai Jiao Tong University, 2022, 56(11): 1518-1531.

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References 38

[1]	张林林, 胡熊伟, 李鹏, 等. 基于极限学习机的电力系统暂态稳定评估方法[J]. 上海交通大学学报, 2019, 53(6): 749-756.
	ZHANG Linlin, HU Xiongwei, LI Peng, et al. Power system transient stability assessment based on extreme learning machine[J]. Journal of Shanghai Jiao Tong University, 2019, 53(6): 749-756.
[2]	徐涛, 陈盼. 动车组弓网离线电磁干扰研究[J]. 中国铁路, 2015, 2015(12): 51-54.
	XU Tao, CHEN Pan. Research on off-line electromagnetic interference of bow net[J]. China Railway, 2015, 2015 (12): 51-54.
[3]	石瑾, 汶斌斌, 于振涛, 等. 心脏起搏器最新进展及发展趋势[J]. 生物医学工程与临床, 2016, 20(6): 639-645.
	SHI Jin, WEN Binbin, YU Zhentao, et al. Recent progress and development trend of cardiac pacemaker[J]. Biomedical Engineering and Clinical Medicine, 2016, 20(6): 639-645.
[4]	HIKAGE T, YAMAGISHI M, SHINDO K, et al. Active implantable medical device EMI estimation for EV-charging WPT system based on 3D full-wave analysis[C]∥2017 Asia-Pacific International Symposium on Electromagnetic Compatibility. Seoul, Korea (South): IEEE, 2017: 87-89.
[5]	MCKERCHAR W D. SAE committee AE-4 electromagnetic susceptibility test program on heart pacemakers[C]∥1972 IEEE International Electromagnetic Compatibility Symposium Record. Arlington Heights, IL, USA: IEEE, 1972: 1-2.
[6]	CAMPI T, CRUCIANI S, DE SANTIS V, et al. Induced effects in a pacemaker equipped with a wireless power transfer charging system[J]. IEEE Transactions on Magnetics, 2017, 53(6): 1-4.
[7]	MATTEI E, CENSI F, MANCINI M, et al. Currents induced by fast movements inside the MRI room may cause inhibition in an implanted pacemaker[C]∥2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Chicago, IL, USA: IEEE, 2014: 890-893.
[8]	CHEN X H, JI J, LOPARO K, et al. Real-time personalized cardiac arrhythmia detection and diagnosis: A cloud computing architecture[C]∥2017 IEEE EMBS International Conference on Biomedical & Health Informatics. Orlando, FL, USA: IEEE, 2017: 201-204.
[9]	DAWSON T W, STUCHLY M A, CAPUTA K, et al. Pacemaker interference and low-frequency electric induction in humans by external fields and electrodes[J]. IEEE Transactions on Bio-Medical Engineering. 2000, 47(9): 1211-1218. doi: 10.1109/10.867951 URL
[10]	KAYE G C, BUTROUS G S, ALLEN A, et al. The effect of 50 Hz external electrical interference on implanted cardiac pacemakers[J]. Pacing and Clinical Electrophysiology, 1988, 11(7): 999-1008. doi: 10.1111/j.1540-8159.1988.tb03944.x URL
[11]	DAWSON T W, CAPUTA K, STUCHLY M A, et al. Pacemaker interference by 60-Hz contact currents[J]. IEEE Transactions on Bio-Medical Engineering, 2002, 49(8): 878-886. doi: 10.1109/TBME.2002.800771 URL
[12]	HIGGINS J V, SHELDON S H, WATSON R E Jr, et al. Power-on resets in cardiac implantable electronic devices during magnetic resonance imaging[J]. Heart Rhythm, 2015, 12(3): 540-544. doi: 10.1016/j.hrthm.2014.10.039 URL
[13]	HUANG D, DONG Z F, CHEN Y, et al. Interference of GSM mobile phones with communication between Cardiac Rhythm Management devices and programmers: A combined in vivo and in vitro study[J]. Bioelectromagnetics, 2015, 36(5): 367-376. doi: 10.1002/bem.21911 pmid: 25864643
[14]	王硕, 张轶珠, 王昕. 干式空心电抗器匝间短路故障投切过电压有限元分析[J]. 电力电容器与无功补偿, 2020, 41(6): 63-70.
	WANG Shou, ZHANG Yizhu, WANG Xin. Finite element analysis of switching overvoltage of dry-type air core reactor[J]. Power Capacitor & Reactive Power Compensation, 2020, 41(6): 63-70.
[15]	MA Q Y, CUI X, ZHANG W D, et al. Simulation of electromagnetic transient characteristics on platform of 1 000 kV fixed series capacitors due to switching operation[J]. Proceedings of the CSEE, 2013, 33(13): 200-211.
[16]	李澍, 郝烨, 王权, 等. 心室辅助装置瞬时高功率能量电磁骚扰评价方法和平台研究[J]. 中国医疗设备, 2019, 34(8): 52-56.
	LI Shu, HAO Ye, WANG Quan, et al. Evaluation method and platform for instantaneous high energy electromagnetic disturbance in ventricular assistant devices[J]. China Medical Devices, 2019, 34(8): 52-56.
[18]	刘兆林, 殷敏莉. 华东500 kV电网短路电流情况的调查[J]. 高压电器, 2008, 44(3): 221-224.
	LIU Zhaolin, YIN Minli. Analysis of short-current failures of the 500 kV power system in East China grid[J]. High Voltage Apparatus, 2008, 44(3): 221-224.
[19]	郭德龙. 地铁牵引变电站负荷运行特性分析[J]. 城市轨道交通研究, 2016, 19(2): 79-82.
	GUO Delong. Analysis of the operation load characteristics at DC traction station[J]. Urban Mass Transit, 2016, 19(2): 79-82.
[20]	崔洪敏, 刘炜, 李鲲鹏, 等. 城市轨道交通牵引变电所负荷过程及概率特性研究[J]. 城市轨道交通研究, 2019, 22(7): 33-37.
	CUI Hongmin, LIU Wei, LI Kunpeng, et al. Study on the load process and probability characteristics of urban rail traction substation[J]. Urban Mass Transit, 2019, 22(7): 33-37.
[21]	宿燕岗, 王蔚, 柏瑾, 等. 磁悬浮列车对心脏起搏系统的影响[J]. 中国心脏起搏与心电生理杂志, 2010, 24(1): 16-20.
	SU Yangang, WANG Wei, BAI Jin, et al. Effect of maglev train on pacemaker[J]. Chinese Journal of Cardiac Pacing and Electrophysiology, 2010, 24(1): 16-20.
[22]	丁一夫, 张悦, 张旭. 电动车辆无线充电系统的电磁安全性[J]. 安全与电磁兼容, 2018(5): 15-19.
	DING Yifu, ZHANG Yue, ZHANG Xu. Electromagnetic safety research on wireless charging system of electric vehicle[J]. Safety & EMC, 2018(5): 15-19.
[23]	包家立. 电磁医疗设备的生物物理基础与应用[J]. 中国医疗设备, 2016, 31(4): 6-13.
	BAO Jiali. Biological and physical principles and applications of electromagnetic medical devices[J]. China Medical Devices, 2016, 31(4): 6-13.
[24]	NAPP A, STUNDER D, MAYTIN M, et al. Are patients with cardiac implants protected against electromagnetic interference in daily life and occupational environment?[J]. European Heart Journal, 2015, 36(28): 1798-1804. doi: 10.1093/eurheartj/ehv135 pmid: 25908772
[25]	IX-IEC. Insulation co-ordination: Part 4. Computational guide to insulation co-ordination and modelling of electrical networks:IEC TR 60071-4—2004[S]. London: BSI, 2004.
[26]	EDLINGER C, GRANITZ M, PAAR V, et al. Visualization and appearance of artifacts of leadless pacemaker systems in cardiac MRI[J]. Wiener Klinische Wochenschrift, 2018, 130(13/14): 427-435. doi: 10.1007/s00508-018-1334-z URL
[27]	LI Y D, MAIMAITIABUDULA M, CAO G Q, et al. A prospective comparison of four methods for preventing pacemaker pocket infections[J]. Artificial Organs, 2021, 45(4): 411-418. doi: 10.1111/aor.13832 URL
[28]	ANDREOZZI E, GARGIULO G D, FRATINI A, et al. A contactless sensor for pacemaker pulse detection: Design hints and performance assessment[J]. Sensors (Basel, Switzerland), 2018, 18(8): 2715. doi: 10.3390/s18082715 URL
[29]	卢武, 李吉程, 黄冬, 等. 电网电磁暂态过程对起搏器植入术后人体电磁环境影响的模拟研究[J]. 高电压技术, 2020, 46(11): 4077-4086.
	LU Wu, LI Jicheng, HUANG Dong, et al. Modelling of electromagnetic field in human body with pacemaker implanted under the influence of transient processes in power network[J]. High Voltage Engineering, 2020, 46(11): 4077-4086.
[30]	LANGLEY P, MURRAY A. Analysis of the atrial repolarisation phase of the electrocardiogram in health and in atrial fibrillation[C]∥2007 Computers in Cardiology. Durham, NC, USA: IEEE, 2007: 785-788.
[31]	MORELLO R, CAPUA C De, BELVEDERE M G. Uncertainty analysis in hemodynamic variables measurement for reliable diagnosis of Pulmonary Hypertension with non-invasive techniques[C]∥2011 IEEE International Symposium on Medical Measurements and Applications. Bari, Italy: IEEE, 2011: 261-266.
[32]	MORAVA J, RICHTER A, KUČERA P. Electromagnetic compatibility of cardiostimulation technology in relation to human body: The introductory study[C]∥World Congress on Medical Physics and Biomedical Engineering 2018. Prague, Czech Republic: Springer, Singapore, 2019: 755-760.
[33]	王晓玲, 牛帅, 仲志真. 含无线技术医疗器械监管思考[J]. 中国医疗器械杂志, 2020, 44(3): 258-262.
	WANG Xiaoling, NIU Shuai, ZHONG Zhizhen. Regulation considerations of medical devices with wireless technology[J]. Chinese Journal of Medical Instrumentation, 2020, 44(3): 258-262.
[34]	BOURKLAND K R. A 34 kA rapid cycling PFN power supply for driving injection magnets[J]. IEEE Transactions on Nuclear Science, 1979, 26(3): 3974-3976. doi: 10.1109/TNS.1979.4330668 URL
[35]	CHEN X Y, SEKINE T, TAKAHASHI Y. Estimation of induced positions of external electromagnetic fields by measuring waveform at both ends of transmission line[C]∥2018 IEEE International Symposium on Electromagnetic Compatibility and 2018 IEEE Asia-Pacific Symposium on Electromagnetic Compatibility. Singapore: IEEE, 2018: 654-659.
[36]	GABRIEL C. Compilation of the dielectric properties of body tissues at RF and microwave frequencies[R]. London: King’s College, 1996.
[37]	石旭东, 董小东, 张和茂, 等. 基于链路参数的屏蔽双绞线串扰预测模型[J]. 计算机应用与软件, 2021, 38(9): 72-77.
	SHI Xudong, DONG Xiaodong, ZHANG Hemao, et al. Crosstalk prediction model for shielded twisted pair based on chain parameter[J]. Computer Applications and Software, 2021, 38(9): 72-77.
[38]	杨坚. 计算机机房雷电感应危害计算分析及防护措施研究[D]. 北京: 中国地质大学, 2007.
	YANG Jian. Calculation analysis of the endangerment by lightning induction and study about its protection for computer room[D]. Beijing: China University of Geosciences, 2007.

分类	典型场景	I_A / kA	H/(A·m^-1)	信号类型	D₁/m
职业暴露场景中的脉冲磁场	水轮机开关动作	5.4	830	缓波	1
	500 kV电力网络单相短路	5.8	892	缓波	1
	电抗器	-	591.5	快波	1
	发电厂电气点检	-	4 070.6	快波	1
	电阻焊	-	4 922.8	快波	-
	变电站电容器组	-	2 769		1
医疗场景中的脉冲磁场	手术电刀	-	1 430	快波	0.1
	眼科激光	-	8 305	快波	0.1
	脉冲治疗仪	-	1 021	快波	0.1
日常生活场景中的脉冲磁场	0.6 kW笔记本电脑开关动作	0.5	79.6	陡波	1
	1 kW空调开关动作	1	159	陡波	1
	6 MW地铁启动	-	79	缓波	1
	磁悬浮	-	80		1
	电动汽车	-	150		1
	动车组弓网离线	-	142		-
	电动车无线充电系统	-	20.05		-

人体组织	l/mm	ε_r	σ /(s·m^-1)	μ_r
皮肤	5	13 182	0.016	1
脂肪	3	95	0.063	1
肌肉	6	9 549	0.32	1
血液	0.8	5 623	0.89	1
心脏起搏器导线	1	5	2.38×10⁶	1

分类	典型场景	H/(A·m^-1)	d_1,w/m
职业暴露场景中的脉冲磁场	水轮机开关动作	830	5.5
	500 kV电力网络单相短路	892	5.9
	电抗器	591.5	3.94
	发电厂电气点检	4 070.6	27.1
	电阻焊	4 922.8	32.8
	变电站电容器组	2 769	18.5
医疗场景中的脉冲磁场	手术电刀	1 430	1
	眼科激光	8 305	5.5
	脉冲治疗仪	1 021	0.7