An interesting article came out a few days ago in Heart Rhythm, raising concern that new hardware in the iPhone 12 may deactivate implanted cardioverter defibrillators (ICDs).
In short, the concern is that an array of magnets in the phone may turn off the life-saving function of these cardiac devices.
This “MagSafe” technology was already used elsewhere, but this is the first time it has been incorporated into an iPhone.
Nearly all ICDs will stop shocking a patient when placed near a sufficiently strong magnet.
Pacemakers exposed to a magnet are set to a pre-programmed mode that varies by manufacturer, usually with a rate of 65-80bpm.
Ask any Emergency Medicine physician and they will be able to point you to a blue circular magnet used for this exact purpose.
A patient with a malfunctioning pacemaker or defibrillator may be suffering numerous inappropriate shocks. The magnet comes in very handy in these situations.
However, a patient that goes into ventricular tachycardia (among other life-threatening cardiac rhythms) will need their device to work appropriately, delivering a shock to save their life.
If this issue is reproduceable in other patients, an iPhone 12 carried in a front shirt pocket has the chance to inactivate the device and block life-saving electrical therapy.
The authors demonstrated this (picture from their publication) using an iPhone 12 on a real patient with an ICD:
Green arrow: iPhone 12 placed over ICD
Red arrow: Interrogation device – “SUSPENDED: Magnet Present”
Yellow arrow: Magnetic ring in iPhone 12
Notice the similar circular layout between the iPhone and the standard blue medical magnet.
Physicians should be aware of this issue. While there is no active litigation related to this, it is a very high risk situation.
MedMalReviewer Opinion:
1. This is unlikely to result in medical malpractice litigation against any individual physician. However, it does place the manufacturer at risk for product liability.
2. ED physicians should keep this in mind for patients with out-of-hospital cardiac arrest. These patients should be completely exposed during the code, removing all clothing and foreign objects.
3. For patients with pacemakers, consider that any unusual or unexplained symptoms could have been explained by a transient switch in pacemaker mode while their phone was nearby. Interrogating the pacemaker will help shed light on this.
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