Pacemaker interference by 60-Hz contact currents.

Contact currents occur when a person touches conductive surfaces at different potentials, thereby completing a path for current flow through the body. Such currents provide an additional coupling mechanism between the human body and external low-frequency fields. The resulting fields induced in the body can cause interference with implanted cardiac pacemakers. Modern computing resources used in conjunction with millimeter-scale human body conductivity models make numerical modeling a viable technique for examining any such interference. An existing well-verified scalar-potential finite-difference frequency-domain code has recently been modified to allow for combined current and voltage electrode sources, as well as to allow for implanted wires. Here, this code is used to evaluate the potential for cardiac pacemaker interference by contact currents in a variety of configurations. These include current injection into either hand, and extraction via: 1) the opposite hand; 2) the soles of both feet; or 3) the opposite hand and both feet. Pacemaker generator placement in both the left and right pectoral areas is considered in conjunction with atrial and ventricular electrodes. In addition, the effects of realistically implanted unipolar pacemaker leads with typical lumped resistance values of either 20 kohms and 100 kohms are investigated. It is found that the 60-Hz contact current interference thresholds for typical sensitivity settings of unipolar cardiac pacemaker range from 24 to 45 microA. Voltage and electric field dosimetry are also used to provide crude threshold estimates for bipolar pacemaker interference. The estimated contact current thresholds range from 63 to 340 microA for bipolar pacemakers.