Magnetic resonance imaging of patients with epicardial leads: in vitro evaluation of temperature changes at the lead tip
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The aim of this study was to systematically investigate the potential heating effects of magnetic resonance imaging (MRI) in the presence of epicardial leads, which are connected to a device or abandoned, using a series of in vitro measurements.
The heating effects of MRI in a 1.5-T scanner were measured at the lead tip in a gel-filled tank. First, a transvenous lead (5086—45 cm, Medtronic) was compared with an epicardial lead (4968—35 cm, Medtronic) with and without connection to an MR-conditional pacemaker. Then, experiments were conducted using various lengths of epicardial leads exposed to MRI.
(1) A temperature rise of + 2.5 °C was observed for the transvenous lead attached to an MRI-conditional pacemaker. The epicardial lead attached to the same pacemaker showed four times higher heating. (2) The transvenous lead without pacemaker showed four times higher heating, and the epicardial lead without pacemaker showed 30 times higher heating. (3) The epicardial lead coiled to 20 cm length without pacemaker showed 9 times higher heating. (4) Experiments with various lengths of epicardial leads showed that the shorter the leads were, the smaller was the heating effect.
Standard clinical MRI investigations may result in pronounced heating at the tip of epicardial electrodes. Epicardial leads, which are not connected to a pacemaker and thus mimicking abandoned leads, may even result in a more pronounced rise in temperature at the lead tip. Therefore, current epicardial pacing systems may carry a substantial risk of inducing thermal damage of the neighboring tissue during MRI scanning.
KeywordsMagnetic resonance imaging Pacemaker Epicardial leads Electromagnetic interference Heating
Christian Balmer: Study concept and study design; data analysis and interpretation, input of pediatric electrophysiology aspects, manuscript draft, and approval of the submitted version.
Matthias Gass: Relevant inputs to study design, critical manuscript revision, and approval of the submitted version.
Hitendu Dave: Relevant inputs to study design, highlighting the surgical aspects, critical manuscript revision, and approval of the submitted version.
Firat Duru: Developing the study protocol, critical manuscript revision, and approval of the submitted version.
Roger Luechinger: Study concept and study design, statistics, data analysis and interpretation, input of technical/engineering aspects, manuscript draft, and approval of the submitted version.
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