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Garofalo RR, Ede EN et al. J Endodon 2002; 28: 831–833

Various dental devices interfere with pacemakers, and the number of patients with them is increasing. Although the EAL was introduced in 1962, no study has yet examined its effect on pacemakers. Manufacturers warn against EAL use in patients wearing pacemakers. EALs measure changed electrical resistance as the canal apex is approached, and their use can reduce X-ray exposure.

A pacemaker set at 60 pulses/min was directly connected (an extreme test) to 5 EALs in turn, with a 150Ω resistor to simulate a canal apex. The pacemaker alone served as negative control, and was linked to an ECG simulator as a positive control. The pacemaker was monitored by telemetry. Only one EAL and the positive control interfered with normal pacing. The authors did not consider the effect of the EAL in question to be significant, and advocate clinical trials to clarify these results.