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May 15, 2007（丹佛讯）－或许你看过这些玩意，小巧的、电子的装置，具有负责的回路与精密的设计，经典的电池，以及一个外部的电线将两个导极分开。在美国有三分之一的人口使用这些装置，目前还没有要求退还的。
iPod（苹果电脑）显然到处都有，但是任何于植入节律器数英吋距离之内发送电子频率的仪器都可能影响节律器的感应功能或是资料传送，暗示这些随身音乐装置应该纳入可能干扰节律器电磁功能的名单中[1]。
Jay P Thaker，一位密西根州Okemos的高中生，他构思这项研究并且与密西根州立大学的医师研究者一同进行这项研究，检验许多iPod的机型，针对100位病患，看是否对节律器会产生任何可测量的作用。这些植入节律器，来自不同制造厂商，包括89个双腔节律器以及11个单腔节律器。Thaker于心脏节律学会2007年科学座谈会中发表这项研究结果。
Thaker与其共同作者针对每一位病患以各种iPod机型进行两种测试，这些测试包括当放置在植入电极发送器2英吋的位置，放送5到10秒，接着审阅装置的事件记录。在800次的独立测试中，其中13.5%（有19位病患）发生过度感应，以与心房或是心室抑制、模式转换、或是高速节律速度有关的假性感应事件定义，37%的检验（有32位病患）发生电磁干扰，且有一例发生节律抑制，以当预期会有节律但未发生来定义。Thaker表示，在那个情况下，iPod对于心室节律的抑制作用是短暂的、但是可再现的。
在25位病患中超过1200次检验，该团队观察到过度感应与电磁波干扰，不论电极摆放位置（单极或是双极），这些过度感应事件与节律模式无关（AAI相对于VVI与DDD），AAI节律器发生电磁干扰显著少于VVI或是DDD模式。Thaker表示，这些干扰事件是具有再现性的，这些事件可以在不同时候、同样的速率下发生。
虽然观察到的干扰并非危及生命的，但是异常的图表结果（高心房或是心室速率）可能会被误认为心房颤动或是心室心搏过速，且可能导致不适当的治疗或是检验。
Thaker的发表得到医师听众的赞美与质疑，在问答时间，Marcelo E Helguera医师（Italiano de Buenos Aires医院，阿根廷）质疑这些发现的重要性；他表示，研究中观察到的电磁干扰经常发生于以电磁棒节律器检验时，且会来自于许多消费性电子装置，例如数位相机或是数位摄影机；他指出，这样的干扰并不是临床上显著的现象。
Richard G Trohman医师（伊利诺州芝加哥Rush大学），该座谈会的共同主席，他表示需要进行iPod对于距离远于2英吋时效果的研究，我猜想，除非病患将iPod放在上衣口袋，其将不会有临床上显著的影响。
根据由心脏节律协会发出的新闻稿，Thaker在阅读行动电话可能对节律器造成干扰的报导后，已经与Krit Jongnarangsin医师（密西根大学，安纳堡）接触有关于进行这样的研究；Jongnarangsin与Thaker接着与密西根州的研究者们合作进行这项研究。
在新闻稿中，双亲都是医师、且父亲是电生理学家的Thaker表示，我们的发现是令人为难的，因为植入节律器的典型病患可能非iPod使用者，他们通常与孙子或是其他年轻重度爱用者紧密接触。
我爱我的iPod…嗯…或许不是[2]
临床上有意义或是没有意义的，iPod的研究发现在世界各地造成回响；然而，这项研究发现是否严重，要看你从何处获得这项讯息。
由路透社记者Debra Sherman撰写广为流传的文章，以平实的标题呈现，iPod可能使节律器功能异常：研究 [3]。该文章以，星期四根据一项由17岁高中生于心脏专家会议中发表的，iPod可能透过干扰其对心脏电磁仪器监测而造成植入节律器功能异常。
同时，Sherman的故事发表在香港虎报上，这是香港一份经济刊物，其标题为iPod影响节律器节律[4]。
Bloomberg的Elizabeth Lopatto写了一篇文章，标题是“研究者指出iPod可能干扰节律器功能”，其开头是“胸口口袋装有iPod时，对抱你的爷爷来说并不是个好主意”[5]。经济记者也引用一项最近来自苹果电脑公司的声明[6]，这份声明提出了有多少常见可能造成干扰的问题：在4月9日，苹果电脑公司表示，iPod随身听的销售量在上市后5年半已经达到1亿台。根据该公司表示，这使得iPod成为史上销售最快的随身听。
CBS广播公司的标题是，年轻研究者表示：iPods会干扰节律器[7]。同时，丹佛邮报医药记者Karen Auge报导一项当地新闻，以“iPod的使用者注意！你的音乐可能会对爷爷的心脏造成伤害，且不仅是因为他不关心其中的歌词”开头[8]。
在英国伦敦，标准晚报以这样的标题描述：听iPod怎么会停止节律器的功能，同时以一张iPod的图片，标题为“健康恐惧：iPod”辅助[9]。
独立经济与法律记者，但为Newsfactor、一项科技新闻刊物撰写的Frederick Lane，在网路文章中表示，过去的一个说法是，一天一颗苹果就可以不用看医生，但是你的iPod可能让你进急诊室[9]。
MacNewsWorld的Fred J Aun表示，iPod的作用原理就像其他的MP3装置，却被不公平地挑出来？举例来说，这些装置是否比行动电话主动发送讯号还要危险 [11]。该报导的标题是，“iPod杀手出击？”。
1. Thaker JP, Patel MB, Li H, et al. iPod干扰节律器功能。心脏节律协会2007科学座谈会; May 10, 2007; Denver, CO. Abstract AB16-1.
2. Townsend E. 我爱我的iPod…嗯…或许不是。PCWorld's Digital World, May 11, 2007. Available at: http://blogs.pcworld.com/digitalworld/archives/2007/05/i_heart_my_ipod.html.
3. Sherman D. 研究显示：iPod可能干扰节律器功能。Reuters, May 10, 2007. Available at: http://www.reuters.com/article/technologyNews/idUSN1048845320070510.
4. Sherman D. iPod扰乱节律器。Standard, May 12, 2007. Available at: http://www.thestandard.com.hk/news_detail.asp?pp_cat=17&art_id=44266&sid=13569448&con_type=1.
5. Lopatto E. I研究显示，iPod可能干扰节律器功能。Bloomberg, May 10, 2007. Available at: http://www.bloomberg.com/apps/news?pid=newsarchive&sid=arcqVBARCtG4.
6. Apple. iPod卖出第一亿台[新闻稿]. April 9, 2007. Available at: http://www.apple.com/pr/library/2007/04/09ipod.html.
7. CBS. 年轻研究者：iPods会干扰节律器。May 11, 2007. Available at: http://cbs5.com/health/health_story_131122309.html.
8. Auge K. 研究显示，听iPod可能使心跳停止。Denver Post, May 11, 2007. Available at: http://www.denverpost.com/search/ci_5866937.
9. 听iPod可能停止你的节律器功能。Evening Standard, May 12, 2007. Available here.
10. Lane F. 节律器受到iPod的干扰。Newsfactor, May 11, 2007. Available at: http://www.newsfactor.com/story.xhtml?story_id=023001BY3XS8.
11. Aun FJ. iPods杀手的攻击? MacNewsWorld, May 11, 2007. Avaliable at: http://www.macnewsworld.com/story/f4PBDZIiTCr8db/Attack-of-the-Killer-iPods.xhtml.
The iPod: Another Source of Pacemaker Interference?
By Steve Stiles
Medscape Medical News
May 15, 2007 (Denver, CO) - Perhaps you've seen them--compact, electronic devices with complex circuitry and sophisticated programming, a state-of-the-art battery, and a single external wire separating into two leads distally. Enough to serve a third of the US population have been sold, yet they are not reimbursable.
The iPod (Apple, Inc) is seemingly everywhere, but any pumping out tunes within a few inches of implanted pacemakers might be altering their sensing functions or telemetry, suggests a study that may add to the list of potential sources of pacemaker electromagnetic interference [1].
Jay P Thaker, a high-school student from Okemos, MI, who had conceived the study and conducted it with physician investigators at Michigan State University, in Lansing, tested several iPod models for any measurable effects on pacemakers in 100 patients. The implanted devices, which were from various manufacturers, included 89 dual-chamber and 11 single-chamber models. Thaker presented the results here last week at the Heart Rhythm Society 2007 Scientific Sessions.
Thaker and his coauthors conducted two tests using each of four iPod models on each patient. The tests consisted of allowing the media players to operate for five to 10 seconds when positioned two inches from the implanted pulse generators, followed by interrogation of the devices' event history. Of the 800 individual tests, 13.5% of them in 19 patients were associated with oversensing events, defined as spurious sensed events associated with atrial or ventricular inhibition, mode switching, or high paced rates. Telemetry interference occurred in 37% of the tests in 32 patients. And there was one instance of pacing inhibition, defined as "failure to pace when pacing was expected." On that occasion, the iPod's inhibiting effect on ventricular pacing was transient but reproducible, Thaker said.
During 1200 more tests in 25 of the patients, the team observed that oversensing and telemetry interference were both independent of lead configuration (unipolar vs bipolar), that oversensing was independent of pacing mode (AAI vs VVI vs DDD), and that telemetry interference events were significantly fewer for AAI pacemakers than for devices in either the VVI or DDD modes. Interference events were reproducible, Thaker said; they were seen to occur at about the same rates on different testing days.
"Although the observed interference was not life threatening, the abnormal histogram findings [high atrial or ventricular rates] may be misinterpreted as atrial fibrillation or ventricular tachycardia and could lead to inappropriate therapy or investigations."
Thaker's presentation met with both praise and skepticism from physicians in the audience. During the question-and-answer period, Dr Marcelo E Helguera (Hospital Italiano de Buenos Aires, Argentina) questioned the significance of the findings. He said that the kind of interference documented in the study is observed "all the time" at his center during pacemaker interrogations using a telemetry wand and can come from a variety of consumer electronic devices, such as video cameras or digital cameras. Such interference, he said, "is not a clinically relevant phenomenon."
Dr Richard G Trohman (Rush University, Chicago, IL), cochair of the session that featured Thaker's presentation, said further studies of any iPod effects from distances further than two inches are called for. "I'm guessing that unless a person has a device and puts a working iPod in a shirt pocket right over the device, that this will not be clinically important."
According to a press release issued by the Heart Rhythm Society, Thaker had approached Dr Krit Jongnarangsin (University of Michigan, Ann Arbor) about conducting the study after reading news reports about pacemaker interference from cell phones. Jongnarangsin and Thaker then teamed with researchers at Michigan State to carry it out.
In the press release, Thaker, whose parents are both physicians and whose father is an electrophysiologist, said, "Our findings are disconcerting because although the typical pacemaker patient may not be an iPod user, they are often in close contact with grandchildren or other young people who are avid users."
"I (heart) my iPod--or, um, maybe not" [2]
Clinically relevant or not, the iPod study's findings found their way around the world in one form or another. How serious they seemed to be, however, depended on where one read them.
The widely circulated article from Reuters reporter Debra Sherman was originally published with the matter-of-fact headline, "iPods can make pacemakers malfunction: study" [3]. The article began, "iPods can cause cardiac implantable pacemakers to malfunction by interfering with the electromagnetic equipment monitoring the heart, according to a study presented by a 17-year-old high school student to a meeting of heart specialists on Thursday."
By the time Sherman's story was published by the Standard, a Hong Kong business publication, it had the headline, "iPod out of tune with pacemaker" [4].
Bloomberg's Elizabeth Lopatto wrote a story headlined, "iPods may interfere with pacemaker function, researchers say," which began, "Hugging grandpa with an iPod in your breast pocket might not be such a good idea, a study suggests" [5]. The business reporter also referred to a recent announcement from Apple [6] that gives some indication of how widespread any interference problem might be: "On April 9, Apple Inc said sales of the iPod music player reached 100 million, five and a half years after the introduction of the device. That made the iPod the fastest-selling music player in history, according to the company."
CBS Broadcasting's story headlined, "Teen researcher: iPods interfere with pacemakers," also had a far reach [7]. And Denver Post medical reporter Karen Auge, covering a local story, began her article with, "Attention, iPod users: Your music might be breaking Grandpa's heart--and not just because he doesn't care for the lyrics" [8].
In London, UK, the Evening Standard ran the story "How listening to an iPod could stop your pacemaker working" and accompanied it with a photo of the music player with the caption, "Health fear: the iPod" [9].
Independent business and legal reporter Frederick Lane, in a story that made the rounds in cyberspace but had been written for Newsfactor, a technology newsletter, led with the warning, "Memo to baby boomers: An Apple a day might keep the doctor away, but your iPod might send you to the emergency room" [10].
Coming to Apple's defense, MacNewsWorld's Fred J Aun wrote, "Are iPods, which work in ways that are essentially very similar to many other MP3 devices, being unfairly singled out? Are they any more dangerous than cell phones, for instance, which actively broadcast signals?" [11]. The story's headline was, "Attack of the killer iPods?"
Thaker JP, Patel MB, Li H, et al. Pacemaker interference with iPod MP3 players. Heart Rhythm Society 2007 Scientific Sessions; May 10, 2007; Denver, CO. Abstract AB16-1.
Townsend E. I (heart) my iPod--or, um, maybe not. PCWorld's Digital World, May 11, 2007. Available at: http://blogs.pcworld.com/digitalworld/archives/2007/05/i_heart_my_ipod.html.
Sherman D. iPods can make pacemakers malfunction: study. Reuters, May 10, 2007. Available at: http://www.reuters.com/article/technologyNews/idUSN1048845320070510.
Sherman D. iPod out of tune with pacemaker. Standard, May 12, 2007. Available at: http://www.thestandard.com.hk/news_detail.asp?pp_cat=17&art_id=44266&sid=13569448&con_type=1.
Lopatto E. IPods may interfere with pacemaker function, researchers say. Bloomberg, May 10, 2007. Available at: http://www.bloomberg.com/apps/news?pid=newsarchive&sid=arcqVBARCtG4.
Apple. 100 million iPods sold [press release]. April 9, 2007. Available at: http://www.apple.com/pr/library/2007/04/09ipod.html.
CBS. Teen researcher: iPods interfere with pacemakers. May 11, 2007. Available at: http://cbs5.com/health/health_story_131122309.html.
Auge K. Hearts don't keep beat with iPods, study hints. Denver Post, May 11, 2007. Available at: http://www.denverpost.com/search/ci_5866937.
How listening to an iPod could stop your pacemaker working. Evening Standard, May 12, 2007. Available here.
Lane F. Pacemakers threatened by iPod interference. Newsfactor, May 11, 2007. Available at: http://www.newsfactor.com/story.xhtml?story_id=023001BY3XS8.
Aun FJ. Attack of the killer iPods? MacNewsWorld, May 11, 2007. Avaliable at: http://www.macnewsworld.com/story/f4PBDZIiTCr8db/Attack-of-the-Killer-iPods.xhtml.
The complete contents of Heartwire, a professional news service of WebMD, can be found at www.theheart.org, a Web site for cardiovascular healthcare professionals.