Some e-cigarettes may interfere with life-saving heart devices

A man uses a vape device in this illustration picture

By Lisa Rapaport

(Reuters Health) - A magnetic part in e-cigarettes may prevent implanted cardiac defibrillators from detecting and treating dangerous heart rhythm problems, a new case report suggests.

"If a patient stores the e-cigarette near the defibrillator - such as in shirt or jacket pocket overlying the device - there is a risk of temporarily disabling the defibrillator's ability to detect and treat a potentially lethal heart rhythm abnormality," said Julie Shea of Brigham and Women's Hospital and Harvard Medical School in Boston, coauthor of the case report.

"To the best of our knowledge, this is the first reported interaction between an electronic cigarette and an implantable defibrillator," Shea said by email.

The report details the experiences of a 48-year-old man who had cardiac sarcoidosis, a rare disease that causes clusters of white blood cells to clump in the heart. The condition can lead to chest pain, shortness of breath and a rapid, irregular heartbeat.

He had an implanted cardiac defibrillator, a device that can detect an irregular heartbeat and deliver an electric shock to the heart to restore a normal heart rhythm.

He also used e-cigarettes, and didn't realize that the JUUL device he used for vaping had an integrated magnetic component.

When he carried the e-cigarette in his left breast shirt pocket, it caused a so-called magnetic reversion in his defibrillator, interrupting the defibrillator's ability to detect or treat an irregular heart rhythm.

Because he wasn't aware of this potential problem, the e-cigarette had blocked his defibrillator four times before he reported it to his healthcare providers, researchers report in Heart Rhythm Case Reports.

He described hearing the device beep several times but said he didn't experience any symptoms along with the sounds and that the device appeared to be working normally.

Upon further questioning, the patient mentioned that he often carried his vape device in his left breast pocket. Researchers then held the e-cigarette up to the defibrillator, and the defibrillator beeped.

JUUL does advise vapers to keep e-cigarettes away from key cards, credit cards and other items with magnetic strips as well as pacemakers, the study team notes.

The authors don't address whether other vape devices have similar magnetic components. They point out that the battery-powered JUUL couples magnetically to its charging dock, and "this magnet is the likely culprit" in their patient's case.

This is just a single case report, and not all e-cigarette users would have defibrillators or carry vaping devices in pockets close to their heart. But the results still suggest that clinicians should warn patients about the potential for this problem to develop, the researchers conclude.

"This patient did not have any adverse health consequences," said Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore.

"But it shows that it is possible for a vaping device to at least temporarily interfere with an implantable cardiac device," Blaha, who wasn't involved in the report, said by email. "The main take-home for patients is that if they have an implantable device, do not hold a vaping device or any other electronic device emitting a magnetic field in direct contact with their chest."

SOURCE: Heart Rhythm Case Reports, online March 16, 2020.