CELLPHONE-INDUCED BRADYCARDIA

Just when you think you’ve seen it all, along comes something new and different. I remember as a younger physician one older doctor saying: “Ah, you ain’t going to tell me something new. I’ve seen it all.” It’s presumptive to think so. But, the allure about being a generalist is encountering a variety of things far and wide.

Such was the case two weeks ago when a nice, middle-aged man, a new patient to the practice, presented for continuation and refills for medication to treat hypertension. I asked if he was a smoker and he said he used to be but he quit and it was only then, he said, that he developed a heart problem. Turns out he used to carry his pack of cigarettes like every other smoker, in his shirt pocket. But after quitting, he began carrying his cellphone in his shirt pocket instead.

It was shortly after that he began developing weak spells, especially when his phone rang. At first it was intermittent then became more frequent. He consulted his doctor in Georgia who confirmed with an EKG that when his phone rang, while in his pocket, that his heart slowed, sometimes very slow. It’s called bradycardia. It was also revealed on a 24-hour Holter monitor, a device a patient wears that digitally records every heartbeat for 24 hours.

He appeared to be very credible, but I found his history difficult to believe since the electromagnetic field from a cellphone is, we are told, not strong enough to cause heart rhythm changes. But this man was credible and convincing. Nevertheless, we asked for the old medical records to validate his claim, so I could see, Doubting Thomas-style, the evidence. But he is the first patient I’ve heard of having a documented case of cellphone-induced heart rhythm problem. Especially one that makes one physically ill.

I posed an inquiry on the website SERMO, a private social network forum for licensed MDs and Dos, but so far no one has experienced anything similar. There is interest and concern regarding cellphone-induced tumors, especially the trigeminal nerve and parotid gland. But no known cardiac effects.

Bradycardia is not pathological unless it causes one to have functional impairments. The former president Jimmy Carter used to run 5 miles daily and had a baseline heart rate of 48. His Secret Service coverage had a challenge keeping up with him.

Anyway, I got to researching in the National Institutes of Health Library reading pertinent studies. There were some, but not a plethora of studies on cellphone-induced problems. It’s surprising how little, at this late date since its invention that we know about the cellphone’s effects on our health and I’m not so sure that much would change if evidence came to be that it was harmful.

Basically, the studies reveal that the cellphone is fairly safe. Numerous large scientific studies have failed to find a causal link between cellphones and brain tumors. But the World Health Organization classifies cellphones as “possible” carcinogens, and there’s a legal caveat (a CYA thing) that comes with every phone that says to keep it at least 10 mm or 5/8 inch away from the body to ensure exposure levels remain at or below the as-tested levels.

Some studies conclude the mobile phone has no effect on heart rate and cardiac electrical activity on healthy volunteers when it is positioned on the chest in immediate proximity to the heart.

But there are other studies that show that the mobile phone increased the variability of heart rate when it was close to the chest, and had minimal effect when close to the head. In other words your heart rate varies, say between around 60 to around 100 when close to the chest. But these were not considered significant changes per statistical analysis.

Significant? Maybe not to the statistician eating a ham sandwich, but to my new patient it was pretty damn significant.

And one study by the American Society of Hypertension showed the blood pressure rose on average by 8 mmHg.

The most concerning study though found that mobile phones increased the QT interval on EKGs in males with heart disease; those with partially clogged coronary arteries. A prolonged, or stretched out, QT interval means the heart takes longer than normal to recharge between beats.

So, at minimum, the studies, while mixed in results, show that the cellphone, while not having been proved to have a deleterious effect on one’s physical state, nevertheless can cause EKG changes in people with heart disease.

However, the absence of evidence does not necessarily mean that an association is non-existent. Interestingly, to my knowledge, there’s no long term study that looks at prolonged, repeated exposure of the cellphone to the population at large, and not small groups.

My recommendations to patients with heart disease, high blood pressure, or high cholesterol, knowing what we know, is: When possible keep phone at a distance. Don’t wear it in your shirt pocket or bra. Use speaker phone when able. Carry it in a case. Since the phone emits less energy when not inside a car or building, use it outdoors when practical. Maybe don’t wear it in your front pants pocket since it’s also been shown to lower sperm count and function. And when possible, keep it in airplane mode.

A perspective about research studies is they never study every single person. Only a group. Then they use statistical analysis to extrapolate the results to the population at large. This means the person who may have a personal idiosyncrasy to some unusual thing can be vulnerable to its ill-effects. Like my new patient, who no longer has an interest in wearing his cellphone in his shirt pocket.