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Background: Smartphones can emit two types of electromagnetic waves, static field from magnet and dynamic field from calling. Previous evidence showed the interference effects from old generation of mobile phones to cardiac implantable electronic device (CIEDs). The current generation of smartphones and CIEDs are reportedly better designed to reduce electromagnetic interference (EMI). We seek to find the presence and the magnitude of EMI from the current generation of smartphones. Objectives: The primary objective was to find out the presence and the effect of electromagnetic interference from current generation smartphones on cardiac implantable electronic devices (CIEDs). The secondary objectives were to demonstrate safety of using current generation smartphones on cardiac implantable electronic devices (CIEDs). Methods: A total of 80 subjects with CIEDs (Pacemaker, ICD, CRT-D, CRT-P) were recruited from our CIEDs clinic. Each subject was tested with three different smartphones (Nokia 3310, Iphone 7, and Samsung Galaxy S9), resulted in a total of 240 tests. Each phone was placed on chest wall, at pulse generator site, at atrial lead level, and at ventricular lead level. During the tests, real-time interrogations were performed to detect any EMI from smartphones in stand-by mode, and during calling-in and out for 30 seconds. After the tests, post-test interrogation was performed to detect any parameters changes. Adverse events including pacemaker inhibition, false ICD shock, CIEDs device malfunction, and urgent electro- physiologist consultations were recorded. Results: 80 subjects (Mean age 70.5 year-old, 50% male) were recruited in the study, and all completed 240 tests according to our protocol. The most common type of CIEDs tested was pacemaker (N=56, 70%), followed by ICD (N=16, 20%), and CRT (N=8, 10%). Most patients (N=62, 77.5%) had more than one lead implanted. The mean age of CIEDs implantation was 5.2 years (Devices were implanted since 2008-2019). Of all the tests performed, no electromagnetic interference (EMI) or adverse events was observed. Conclusion: Current generation of smartphones have no EMI effect to CIEDs and can be used safely without any adverse events including pacemaker inhibition, false ICD shock and CIEDs malfunction.

Transvenous Lead Extraction (TLE) is a standard treatment for some late Cardiac Implantable Electronics Device (CIED) complications. The outcome of transvenous lead extraction procedure in Thailand is not robust.A Single-center retrospective cohort of TLE procedures performed at Ramathibodi hospital between January 2008 and December 2020 was studied.There were 157 leads from 105 patients who underwent lead removal procedure during the specified period. Data analysis was performed from 79 TLE patients due to incomplete data and lead explant procedure of the excluded subjects. Mean patients' age was 57.7 ± 18.7 years, with 70.9% male. There were 82 pacemaker leads, 35 ICD leads, and 5 CS leads (mean number of leads were 1.54 ± 0.66 per patient), with mean implanted duration of 87.8 ± 68.2 months. Main indication for TLE was infection-related, which accounted for 67.1% of the cases. Overall clinical success rate was 97.5%. Mean operative time was 163.8 ± 69.5 min. Major complications occurred in 4 patients (5.1%) with one in-hospital mortality from severe sepsis.TLE using laser sheath and rotating mechanical sheath for transvenous lead extraction is effective and safe, even outside high-volume center.

Post-infarct ventricular septal rupture is life-threatening condition, challenging in management. Surgical and transcatheter approach are treatment of choices. A 53 year-old female presented with chest pain for 1 day. Electrocardiogram had ST-elevation on inferior leads. Echocardiogram revealed