Ferrick, et al., report that cosmic radiation is a well-known cause of single-event upsets (SEU) on disruption to electrical circuits in electronic devices. It most commonly occurs and is reported for devices such as laptop computers, cell phones, and personal digital assistants. We report 3 patients with implantable cardioverter-defibrillators (ICDs) who experienced SEUs during air travel that may be attributed to exposure to cosmic radiation while on commercial airline flights. These cases highlight the significant impact of SEUs on ICDs and patient clinical outcomes and the need for further recognition and study of this problem.
Cosmic rays can typically penetrate 4 feet of concrete. Total elimination of cosmic radiation effects on electronic devices is impossible. Failsafe mechanisms internal to electronic devices are error correction codes performing critical redundancy checks that verify the integrity of bits. The frequency of these checks depends on the device manufacturer. If one bit is altered in position, or “flipped,” it can be programmed to correction. However, if there are multiple bits found flipped during a given critical redundancy check, the device resets. The result of the reset is typically to nominal programmed parameter settings with a stamped log of the exact date and time of the event.
Their device follow-up clinic recently observed SEUs with device electrical resets in 3 ICD patients, all occurring while the patients were on commercial airline flights. Two patients were returning to New York City from the Dominican Republic and Ghana. The third patient was traveling from New York City to Paris.
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