Translation of a-t 2024; 55: 63
IN BRIEF
Pacemakers and ICDs – be careful in the swimming pool
A nine-year-old girl with a pacemaker reports lightheadedness when swimming in her neighbours' above-ground pool in late summer. A 61-year-old man with a CRT-D device (cardiac resynchronisation therapy with defibrillator) is swimming in the hotel pool on holiday in the Caribbean, gets close to the underwater lamps at the pool bar and feels lightheaded too. He moves away and the symptoms ease.1 Both devices recorded artifacts in the periods in question and misinterpreted them as the heart's own actions, which was followed by modeswitches to inhibit pacing, in each case without any serious consequences. These could be possible, though: changes in pacing mode can lead to bradycardia, asystole and atrioventricular dyssynchrony.1-3 The 61-year-old's device also initiated antitachycardia pacing (ATP, stimulation to terminate tachyarrhythmias).4 His device did not deliver a shock,1 but the devices of two other swimmers in pools did, according to other reports.5,6 A 31-year-old with an implantable cardioverter defibrillator (ICD) experienced multiple discharges when diving in a public pool. Once acute cardiac causes and device failure had been ruled out, suspicion fell on an electric motor that recycles the chlorinated water and had defective grounding.7 If electrical components in a swimming pool such as filters or lamps are not appropriately grounded or insulated, this can cause malfunctions in pacemakers and ICDs through electromagnetic interference.1 Although the reports outlined are individual cases, wearers should be informed about the potential risk of interference with their device when swimming in pools, particularly private pools or pools where the usual safety standards may not have been complied with.1
| * | Previous version published on 19 July 2024 as blitz-a-t. |
| 1 | CONTE, L.M. et al.: Ann. Intern. Med. Clin. Cases 2024; 3: e240072 (4 pages) |
| 2 | NAPP, A. et al.: Kardiologe 2019; 13: 216-35 |
| 3 | NAPP, A. et al.: Eur. Heart J. 2015; 36: 1798-804 |
| 4 | CANTILLON, D.J., WILKOFF, B.L.: Heart Rhythm 2015; 12: 1370-5 |
| 5 | WIGHT, J., MICHAEL, S.L.: Heart Rhythm Case Rep. 2019; 5: 260-1 |
| 6 | MAKARYUS, J.N. et al.: Tex. Heart Inst. J. 2014; 41: 61-3 |
| 7 | ROBERTO, E.S.: Case Rep. Cardiol. 2017; 2017: 6714307 (4 pages) |
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