Effects of magnetic resonance imaging on cardiac pacemakers and electrodes

Achenbach, Stephan; Moshage, Werner; Diem, B.; Bieberlea, Tobias; Schibgilla, Volker; Bachmann, K.

doi:10.1016/s0002-8703(97)70083-8

Cited by 224 publications

(155 citation statements)

References 12 publications

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“…The electrode tips are generally considered the locations most likely to demonstrate the largest temperature change [36,37]. To confirm this we performed a number of pilot experiments placing the sensors at the point of entry of the electrodes into the gel, the strip electrode, the grid and depth electrodes.…”

Section: Temperature Measurementsmentioning

confidence: 99%

Feasibility of simultaneous intracranial EEG-fMRI in humans: A safety study

Carmichael¹,

Thornton

Rodionov³

et al. 2010

NeuroImage

111

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In epilepsy patients who have electrodes implanted in their brains as part of their presurgical assessment, simultaneous intracranial EEG and fMRI (icEEG-fMRI) may provide important localising information and improve understanding of the underlying neuropathology. However, patient safety during icEEG-fMRI has not been addressed.Here the potential health hazards associated with icEEG-fMRI were evaluated theoretically and the main risks identified as: mechanical forces on electrodes from transient magnetic effects, tissue heating due to interaction with the pulsed RF fields and tissue stimulation due to interactions with the switched magnetic gradient fields.These potential hazards were examined experimentally in-vitro on a Siemens 3 T Trio, 1.5 T Avanto and a GE 3 T Signa Excite scanner using a Brain Products MR compatible EEG system. No electrode flexion was observed. Temperature measurements demonstrated thatheating well above guideline limits can occur. However heating could be kept within safe limits (<1.0°C) by using a head transmit RF coil, ensuring EEG cable placement to exit the RF coil along its central z-axis, using specific EEG cable lengths and limiting MRI sequence specific absorption rates (SARs). We found that the risk of tissue damage due to RF-induced heating is low provided implant and scanner specific SAR limits are observed with a safety margin used to account for uncertainties (e.g. in scanner-reported SAR). The observed scanner gradientswitching induced current (0.08mA) and charge density (0.2μC/cm 2 ) were well within safety limits (0.5mA and 30μC/cm 2 , respectively).3

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Section: Temperature Measurementsmentioning

confidence: 99%

Feasibility of simultaneous intracranial EEG-fMRI in humans: A safety study

Carmichael¹,

Thornton

Rodionov³

et al. 2010

NeuroImage

111

View full text Add to dashboard Cite

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“…Experimental in vitro measurements of the temperature increase at the lead tip of PMs/ICDs during RF exposure show widely varying results, with values ranging from negligible degrees up to more than 60 C (11,17,18,21,30,31). Most of these studies focused only on the induced heating at the lead tip, whereas the temperature increase at the ring of bipolar leads is either considered negligible or even not mentioned.…”

Section: Discussionmentioning

confidence: 99%

Role of the lead structure in MRI‐induced heating: In vitro measurements on 30 commercial pacemaker/defibrillator leads

Mattei¹,

Calcagnini²,

Censi³

et al. 2011

Magnetic Resonance in Med

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MRI-induced heating on endocardial leads is a serious concern for the safety of patients with implantable pacemakers or cardioverter-defibrillator. The lead heating depends on many factors and its amount is largely variable. In this study, we investigated the role of those structural properties of the lead that are reported on the accompanying documents of the device: (1) fixation modality (active vs. passive); (2) number of electrodes (unipolar vs. bipolar); (3) length; (4) tip surface; and (5) tip and ring resistance. In vitro temperature and specific absorption rate measurements on 30 leads (27 pacemakers, three implantable cardioverter-defibrillator leads) exposed to the radiofrequency field typical of a 1.5 T MRI scanner are presented. The data show that each lead has its own attitude to radiofrequency-induced heating and that the information that is available in the accompanying documents of the pacemaker is not sufficient to explain such attitude. Even if combined with that of the implant geometry, this information is still not sufficient to estimate the amount of heating due to the exposure to the radiofrequency field during MRI examination. Magn Reson Med 67:925-935,

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“…The potential adverse interactions between the pacemaker and MRI include the inhibition of pacemaker exit, pacemaker warming, pacemaker vibration, asynchronic stimulation of the pacemaker, induction of atrial fibrillation, induction of ventricular fibrillation, switch mode malfunction, rapid atrial stimulation, rapid ventricular stimulation, and alteration in the pacemaker programming with potential damage to the pacemaker circuit or system dislocation [5][6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

“…Malfunction of the PM results from interference with radiofrequency during MRI performance and may cause total inhibition in the atrial and ventricular exit, or, on the contrary, may cause dangerous stimulation at high frequencies in the chambers, leading to atrial or ventricular fibrillation and consequent deleterious effects 3,[5][6][7] .…”

Section: Discussionmentioning

confidence: 99%

“…Another adverse effect caused by the radiofrequency energy is warming of the electrodes, which should be considered when patients are exposed to MRI, this being the factor that causes precordial discomfort during the examination and change in the PM command threshold 1,6 . Therefore, MRI performance in patients with PM is formally contraindicated.…”

Section: Discussionmentioning

confidence: 99%

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