Interference of high 50/60-Hz electric and magnetic fields with the normal functioning of active cardiac implants: implications for newly implanted workers returning to or entering work in the utility sector.

The 50/60-Hz electric and magnetic fields in substations or under high-voltage lines may interfere with the operation of cardiac implantable electronic devices (CIEDs). This review of the literature over the last 20 years provides guidance to occupational physicians who give orientations when newly implanted workers return to or enter work. For magnetic fields, CIEDs are generally not affected up to 100 μT. For electric fields, CIEDs set to nominal sensitivity and in bipolar mode are unaffected up to 5 kV/m. Clinically significant or symptomatic disturbances are unlikely up to 10 kV/m. Specific advice may be necessary for patients implanted in unipolar mode or with very low sensitivity thresholds. Some atrial configurations in the presence of high electric fields may require special attention. Two approaches are used when entering or returning to work: compliance with restrictions relative to exposure to electric and magnetic fields, or particular workstation tests under medical supervision.