Interference

Four years ago I was told I needed a pacemaker. I got a second opinion from a rhythm clinic at a hospital where my husband was a cardiovascular and thoracic surgeon. They said I didn't need one. Ten days ago I was implanted with a Boston Scientific for Sick Sinus Syndrome in Costa Rica where I live. I am extremely grateful for the information on this sight. Sometimes things get lost in translation. I have a lap pool with a saline chlorination system that uses electrolysis which is a source of electrical current in pools. The amount of leakage apparently is not standardized. The NIH says the shock can be particularly dangerous while swimming. This may be a stupid question, (/I was a fine arts major, but if I turn off the chlorinator can I swim? Or does the electrical current stay in the pool?


7 Comments

Chlorine

by piglet22 - 2024-03-18 05:21:38

Hello

What is a lap pool? Is it seawater or do you add salts to it when you use it?

Electrolysis of water containg sodium chloride will certainly produce chlorine gas, but is unusual in UK practice.

It will involve a system of electrodes passing a current between them. It can work at low voltage, say 12 volts, which is considered safe to be in contact with. It's called SELV or Safety Extra Low Voltage.

Any electrical field will be localised at the electrodes unless a fault developed.

If you use the chlorine for disinfection, why not use a chemical method like chlorine tablets?

Under the brand name Fichlor (used to be made by Fisons), it contains SDIC or Sodium Dichloroisocyanurate.

I use it together with ultraviolet lamps to disinfectant rainwater. It's a lot safer to use than commercial bleach which is very alkaline and corrosive.

A lot depends on the size of the the pool and what you use it for.

I can't see any problem with your pacemaker, provided everything is electrically safe. It's particularly important to make sure that the equipment is isolated from mains electricity or the gas production equipment is isolated from the pool water.

Seawater has a very high conductivity and will pass electrical current as well as a copper wire. Adding any salts of any composition to water makes it a lot more conductive.

Presumably you check the chlorine level. In the UK, chlorine is added as a gas from cylinders to potable water for drinking at a level as low as a few ppm (parts per million).

What I can't tell you is that it's completely safe to use your system with a pacemaker. That can only come from the manufacturer and your medics.

Chlorine tablets are safely used in domestic swimming pools and is likely to be easier to control. Keep in mind that chlorine gas is very toxic and was used and still is, as a poison gas in warfare. The Syrians reputedly used it against their own population.

lap pool

by new to pace.... - 2024-03-18 07:08:27

Piglet22 and others it is  the size  to be used to make it easier to swim laps. More long and  narrow rather then wider as in regular pools in the US.

Some people think a salt water pool is better that chlorine.

new to pace

Living with a pacemaker for the technophobe

by Gotrhythm - 2024-03-18 14:04:59

I hear you about the challenges of being someone whose brain isn't  equipped for a trip through Technoland.
Ready or not, though, here we are with a piece of high tech electronics permanently implanted. My experience indicates we don't need to return to college and get a BS degree. But we do need to learn to ask the right questions.

Being a curious sort, I read what I assume was the NIH article on pacemakers and pools with saline electrolysis filtration systems.

Right away, the first question I had was what kind of pacemaker do you have? Is it a simple pacemaker, or is it an ICD or CRT? What is your diagnosis? You said, SSS, but does that mean just bradycardia, or is there a more complex arrythmia?

Finally, what percentage are you paced? It can range from less than 10% all the way to 100%. A person paced 10% or less probably would never notice inteference even if it did occur. 

The reason understanding your diagnosis matters is that in one of the (only!) two cases cited, the person had heart block. The other person had an ICD, the kind of device that delivers a shock to the heart. If I read the article right, the shock they were talking about was an inappropriate shock delivered by the ICD device--NOT the pool

When evaluating possible danger of any inteference, you need to understand that the inteference will not damage your pacemaker in any way or cause it to fail. In most cases, even if the rare intefernce happens, it is no danger to you.

As soon as you move away from whatever is causing the inteference, your pacemaker will resume its programming like it never happened.  Kind of like listening to the radio on your car. Sometimes you encounter some inteference. You hear some static but when you drive on, the station comes in perfectly again. The radio wasn't harmed at all.

Here's a small caveat. Frankly, as I read the ariticle I didn't understand what the writers meant by "current leakage."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522425/

Perhaps one of our more techno-savvy members will read the article and explain it.

In the meantime, if you don't have heart block or an ICD, I'd say, don't worry about it. Use your lap pool and enjoy it. You may need to talk to your cardiologist about the optimal adjustment of your pacemaker, specifically for swimming.

Our pacemakers are incredibly reliable devices that mostly don't save our lives, meaning we wouldn't die if they failed--pacemakers just give us a chance at a life that's worth living. Which includes using a pool.

 

 

 

 

Current leakage

by crustyg - 2024-03-18 19:56:51

It might come as a surprise to know that when we are connected up to an ECG (EKG) there is sometimes a tiny current that flows from the ECG machine into our bodies - this is after all a machine connected to live mains voltage and it has semiconductors as amplifiers connected to the other end of each of the 12 leads that they connect up.  This leakage is *very* carefully controlled and there are strict limits on what the device may leak towards the patient.  Reassuring I think.

By contrast there doesn't appear to be a standard or limit about the leakage from saline electrolysis systems (according to the paper), and this *might* be a cause for concern.  I suspect (hope might be more honest) that each saline electrolysis vendor has designed their equipment to their own standard which they might be prepared to share with a customer.  IEC60601-1 is used as the standard for biomedical equipment in many/most developed countries (normal patient leakage 100uA maximum) and the saline electrolysis vendors might have chosen to try and meet the IEC standard, or come close to it.

Best wishes.

Leakage current

by piglet22 - 2024-03-19 07:45:20

Leakage current is basically where an electric current doesn't follow the intended path.

Electrical installations are often protected against these faults by having devices that detect that the current flow is not the same in the live and neutral lines (UK names, hot or neutral elsewhere)

These devices are called ELCD (Earth Leakage Current Device) or RCD.s.

They operate at extremely small currents in the milliamp level and cut the mains power before it damages us.

Leakage is normally from the positive or live side to earth and this is where it gets dangerous.

If you happen to be connected to the earth, be it a copper pipe or a swimming pool filled with seawater, you are going to be in trouble, pacemaker or not.

It's why showers and baths have to be isolated from any possible contact with mains electricity.

In the UK, the bathroom is divided into zones and the area where you contact the water is considered the most dangerous and only SELV equipment is allowed. That means 12 volts or less

Medical equipment has even more stringent controls on leakage current as crustyg mentioned.

I've commented before about deliberate shocks as used in nerve conduction tests.

It doesn't take much current in the dentist chair for even equipment generated voltages (ultrasonic descalers for instance) to get you jumping around.

Leakage is to be avoided and it matters.

Maybe not many pacemaker patients get to experience PM induced unwanted side effects but when my device failed 8 years ago, I got to find out what it's like to have your arm making involuntary movements at 60 twitches per minute.

Swimming pool saline chlorination units and implantable cardiac devices: A source for potentially fatal electromagnetic interference

by Good Dog - 2024-03-19 07:51:04

I read the aforemention and have to say that there is scant evidence of any serious issues. The key word being "potential" I guess. However, as everyone knows, water is a great conductor of electricity. If you look hard enough you can find many documented incidences of people feeling a tingling sensation while swimming due to currents induced by malfunctioning pool equipment. That would be pump motors, electrical outlets and ancillary equipment such as lighting. What I did find interesting is the fact that "episodes of significant atrial and ventricular noise" (interference) was seen in a PM interrogation while a woman was swimming in a pool with saline chlorination.  

Now realistically, I do not think that any of that poses a serious danger IMHO. Even the electrical noise found during a PM interogation really did not pose a serious problem. These PM's are shielded so well against EMI and it generally does not pose a serious threat. However, we have to acknowledge that in a saline pool (salt chlorination), there is at least some very, very small potential. I would think maybe more so with an ICD delivering a shock than perhaps anything else. Although, much of that is just supposition on my part. I have always been a bit of a risk taker with my PM. What better way to determine the tolerance than actually testing it (if you don't have an ICD) by swimming to see how you feel (which is what matters) and asking your PM tech to look for any noise or other issues that could have presented themselves. However, that is just me. I did that using a chain saw, working around 11,000 volt 4,000 h.p. electric motors and standing next to an operating turbine generator at the Niagara Falls Power Station. Never a problem! Now I am not suggesting that anyone else should do what I have done. I have never swum in a pool with a salt/chlorine generator. You must use your own judgement based on your personal risk tolerance.

Sincerely,

Dave

Interference

by GNU - 2024-03-21 13:21:40

Thank you everyone for your input. I've decided just to be on the safe side, I'll turn off the Salinator when I swim. This isn't an option for people swimming in a large public pool.

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