Impact of handheld and wearable electronics on programmable shunt valves

CSF diversion through ventricular shunt placement is a mainstay of hydrocephalus treatment, and the advent of programmable shunt valves in the last 40 years has continued to improve treatment options. Programmable shunt valves allow noninvasive setting adjustment with magnetic programming devices. However, since there are objects in everyday life that emit magnetic fields, the shunt valve setting may be unintentionally changed. The authors aimed to summarize the current literature on handheld, wearable, and earpiece devices and their impact on programmable shunts, as well as explore the effect of the magnetic field of handheld and wearable electronics when actively in use in common positions on programmable shunt valve settings.

The following reprogrammable shunt valves were tested: Medtronic Strata II, Codman Hakim, and Codman Certas. The electronic devices used were Apple AirPods Pro 2, Bose QC 45, Oculus Meta Quest 3, Apple iPad 6, and Apple iPhone 15. A shunt valve with a predetermined setting was attached to the skull model in the right parieto-occipital and right frontal locations. The devices in their active mode were placed on or around the ear for a minimum of 5 minutes. The shunt valve setting was then rechecked. As rotary motion may impact magnetic fields, secondary testing with various motions was performed and the shunt setting was rechecked.

The programmable shunt valves were set as follows: Medtronic Strata II at 1.5, Codman Hakim at 70 mm H2O, and Codman Certas at 4. After a minimum of 5 minutes of realistic interaction with the aforementioned electronics, the shunt setting was rechecked. The shunt setting remained the same in each case tested.

It is safe for children and adults with hydrocephalus and programmable shunt valves to use common handheld and wearable electronics without concern for their shunt valve setting being affected unknowingly.