Tandem e-cigarette, implantable cardioverter defibrillator use causes rare, potentially fatal consequence
A magnetic component of a Juul electronic cigarette came into close contact with a implantable cardioverter defibrillator (ICD) and caused a rare but potentially fatal interaction in a man aged 48 years with a history of cardiac sarcoidosis, according to a paper in Heart Rhythm Case Reports.
The magnet feature in the implantable cardioverter defibrillator (ICD) is a special safety feature built into the device in case physicians had to “temporarily suspend the ICD’s detection and any therapies during surgical procedures,” Julie B. Shea, MS, RNCS, FHRS, an electrophysiologist nurse practitioner at Brigham and Women’s Hospital, told Healio Primary Care.
After the ICD was installed, the patient told doctors that he heard the device emit a “single steady tone” several times. He had no other symptoms and his ICD had not been reprogrammed. Medtronic, the ICD’s manufacturer, identified four magnet interactions with the device that corresponded with the dates and times the man heard the questionable tone. The man then recalled that he frequently stored his Juul in his left breast pocket overlying the device, revealing the tone’s cause.
“During those times of magnetic interactions with the e-cigarette, the implantable cardioverter defibrillator was temporarily suspended,” Shea said. “If the patient happened to have a lethal ventricular heart rhythm abnormality at the time, the implantable cardioverter defibrillator would not have recognized it and the outcome possibly fatal.”
She said the man’s experience is believed to be the first of its kind, but health care professionals should still inform patients that magnets must be stored at least 6 to 12 inches from implantable cardioverter defibrillators.
Upon reviewing Shea and colleagues’ paper, Juul spokesperson Kevin Harris told Healio Primary Care that “Juul Labs takes product quality and consumer safety very seriously and implements stringent quality control measures in the manufacturing process of all our products.”
Harris added that customers should follow manufacturer instructions and warnings for any electronic devices that can be affected by magnets and discuss interferences such as the one described in Shea and colleagues’ paper with their health care provider.
Medtronic did not respond to a request for comment for this story. – by Janel Miller
Disclosures: Harris works for Juul. Shea reports no relevant financial disclosures. Please see the paper for all other authors’ relevant financial disclosures.
Editor's Note: This story has been corrected since its original posting.