Magnetic field interactions of smartwatches and portable electronic devices with CIEDs-Did we open a Pandora?s box?

Introduction: Magnetic interaction of portable electronic devices (PEDs), such as state-of-the art mobile phones, with cardiovascular implantable electronic devices (CIEDs) has been reported. The aim of the study was to quantify the magnetic fields of latest generation smartwatches and other PEDs and to evaluate and predict their risk of CIED interactions.Methods: High resolution magnetic field characterization of five smartwatches (Apple Watch 6/7, Fitbit Sense, Samsung Galaxy 3, Withings Scanwatch) was performed using a novel magnetic field camera. Ex vivo mea-surements of the minimal safety distance (MSD) at which no mode switch can be observed were performed between 11 PEDs and six representative CIEDs.Results: Maximal 1 mT distances ranged between 10 mm (Withings) and 19 mm (Fitbit and AppleWatch), and 1 mT volumes between 6 cm3 (Withings) and 19 cm3 (Fitbit). All these measures were observed only for the back side of the smartwatches. While most smartwatches with measured 1 mT distance < 15 mm posed low ex vivo interaction within a distance of < 10 mm, PEDs such as electronic pens and in-ear-headphones with measured 1 mT distance > 15 mm showed device interaction up to > 15 mm. Linear regression analysis showed a linear relationship of the MSD with 1 mT distance (B coefficient: 0.46; 95 %-CI: 0.25-0.67, p < 0.001). Conclusion: Smartwatches are safer compared to other PEDs such as electronic pens or in-ear headphones with regards to CIED interaction. With a standardized magnetic field camera, the risk assessment of CIED interaction of novel PEDs is feasible.