Abstract
Background Bioelectrical impedance analysis (BIA) is widely used to assess body composition. However, its safety in patients with cardiac implantable electronic devices (CIEDs) remains uncertain owing to potential electromagnetic interference (EMI). Objective This study aimed to evaluate potential complications associated with clinical-grade BIA use in patients with CIEDs, based on currently available evidence. Methods We conducted a systematic review of studies published up to December 26, 2024, identified through PubMed, Embase, Scopus, and the Cochrane Library. The primary outcome was the occurrence of adverse events, including EMI, device malfunction, or arrhythmias. Results Of 3668 records, 6 cohort studies (n = 531 patients) met the inclusion criteria. These included patients with pacemakers (n = 175), implantable cardioverter-defibrillators (n = 268), and cardiac resynchronization therapy defibrillators (n = 154). BIA protocols varied in frequency (5–500 kHz) and current intensity (typically ≤0.8 mA). No study reported clinically significant EMI, device malfunctions, or BIA-induced arrhythmias. Device parameters (eg, lead impedance, pacing thresholds) remained stable before and after BIA exposure. Risk of bias was rated as good in 1 study and fair in 5. Conclusion Current evidence suggests that clinical-grade BIA is safe in patients with CIEDs, with no reported adverse effects or device interferences. These findings contribute to informing and potentially updating previous recommendations that discouraged BIA in this population. However, further high-quality studies are needed to confirm safety across different BIA protocols and device types. Importantly, these findings apply to clinical-grade BIA and should not be extrapolated to consumer-grade wearables, which may present a theoretical risk of CIED interference.
Document Type
Journal Article
Date of Publication
12-1-2025
Volume
6
Issue
12
Publication Title
Heart Rhythm O2
Publisher
Elsevier
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
Funders
Forrest Research Foundation Scholarship / Edith Cowan University
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
First Page
1985
Last Page
1992
Comments
Uribe-Cavero, L. J., Chavez-Ecos, F. A., Camacho-Caballero, K., Grados-Pintos, J. C., Vera-Maccha, P., Siguas-Huasasquiche, A., Sharma, D., & Toro-Huamanchumo, C. J. (2025). Safety of bioelectrical impedance analysis in patients with cardiac implantable electronic devices: A systematic review. Heart Rhythm O2, 6(12), 1985–1992. https://doi.org/10.1016/j.hroo.2025.09.026