Effect of magnetic resonance imaging on DDD pacemakers

Erlebacher, Jay A.; Cahill, Patrick; Pannizzo, Frank; Knowles, R.

doi:10.1016/0002-9149(86)90768-x

Cited by 128 publications

(58 citation statements)

References 1 publication

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“…The potential effects of MRI on PMs, ICDs, and other active implantable medical devices (AIMDs) include: force and torque effects (7,8); an undefined reedswitch state within the static magnetic field (9); the potential risk of heart stimulation and inappropriate pacing (10,11); and heating effects at the lead tip (12)(13)(14).…”

mentioning

confidence: 99%

In vitro investigation of pacemaker lead heating induced by magnetic resonance imaging: Role of implant geometry

Calcagnini¹,

Triventi²,

Censi³

et al. 2008

Magnetic Resonance Imaging

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Purpose:To evaluate the effect of the geometry of implantable pacemakers (PMs) on lead heating induced by magnetic resonance imaging (MRI). Materials and Methods:In vitro experiments were conducted with two different setups, using fluoroptic probes to measure the temperature increase. The first experiment consisted of a rectangular box filled with a gelled saline and a pacemaker with its leads. This box was exposed in an MRI birdcage coil to a sinusoidal 64-MHz field with a calibrated whole-body specific absorption rate (WB-SAR) of 1 W/kg. The highest SAR and temperature increase (3000 W/kg, 12°C) occurred for the implant configuration having the largest area. The second experimental setup consisted of a human-shaped torso filled with gelled saline. In this setup the PM and its lead were exposed to a real MRI scanner, using clinical sequences with WB-SAR up to 2 W/kg. Results:We found that higher heating occurs for configurations with longer exposed lead lengths and that right chest PMs showed the highest temperature and local SAR (11.9°C, 2345 W/kg), whereas the left chest PMs were less heated (6.3°C, 1362 W/kg). Implant geometry, exposed lead length, and lead area must be considered in the wide variation of temperature increases induced by MRI. Conclusions:The amount of MRI-induced lead tip heating depends strongly on implant geometry, particularly the lead area, exposed lead length, and position of the implant in the phantom. Critical lead tip heating was found for the longer leads. Therefore, to minimize MRI-induced lead tip heating, the PM lead should be as short as possible.

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mentioning

confidence: 99%

In vitro investigation of pacemaker lead heating induced by magnetic resonance imaging: Role of implant geometry

Calcagnini¹,

Triventi²,

Censi³

et al. 2008

Magnetic Resonance Imaging

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“…2,3,11 The effect of medical appliances, such as magnetic resonance imaging or an electrosurgical knife, on an implanted pacemaker presents a similar problem. [4][5][6] High-dose irradiation equipment can interfere with pacemaker function, which necessitates re-programming, and may even permanently damage the pacemaker. [12][13][14][15][16] According to the existing American Association of Physicists in Medicine Task Group 34 Guidelines, 17,18 the total irradiation exposure level of a pacemaker in patients receiving radiotherapy should not exceed 2.0 Gy.…”

Section: Discussionmentioning

confidence: 99%

“…1 Clinically, a variety of medical appliances that produce electromagnetic or radiofrequency waves are now used for diagnostic or therapeutic purposes, and precautions or restrictions on their use have been enforced to protect patients with an implanted pacemaker from possible hazards. [2][3][4][5][6] Computed tomography (CT) is widely used in clinical practice, but a detailed report has not been published of the effects of CT scanning on the operation of pacemakers. Although it is commonly believed that CT scanning does not affect the functioning of pacemakers, we have previously reported a transient malfunction of the pacemaker probably caused by over-sensing.…”

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confidence: 99%

Does High-Power Computed Tomography Scanning Equipment Affect the Operation of Pacemakers?

Yamaji

Imai

Saito

et al. 2006

Circ J

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alfunctioning of a pacemaker because of electromagnetic interference (EMI) was reported after development of the demand pacemaker. 1 Clinically, a variety of medical appliances that produce electromagnetic or radiofrequency waves are now used for diagnostic or therapeutic purposes, and precautions or restrictions on their use have been enforced to protect patients with an implanted pacemaker from possible hazards. [2][3][4][5][6] Computed tomography (CT) is widely used in clinical practice, but a detailed report has not been published of the effects of CT scanning on the operation of pacemakers. Although it is commonly believed that CT scanning does not affect the functioning of pacemakers, we have previously reported a transient malfunction of the pacemaker probably caused by over-sensing. 7 The present study was undertaken to examine the influence of multislice spiral CT on pacemakers in patients and experimental models of the human body. Methods ECG Monitoring During Chest CT Scanning in Pacemaker-Implanted PatientsIn 11 patients with implanted demand-type pacemaker, chest CT scanning using a multislice spiral CT system (4-detector row, SOMATOM Volume Zoom, Siemens, Germany) was performed for further evaluation of abnormal shadows that had been observed on chest X-ray.During the CT scanning, the ECGs of the extremity leads were recorded at a paper feed rate of 25 mm/s. All patients gave informed consent. Measurement of Alternating Electric and Magnetic Fields in the CT Room and on CT Scan LinesThis experiment was conducted to examine whether the CT procedure produces electromagnetic fields in the CT room and induces EMI with pacemakers. Alternations of the electric and magnetic fields on the CT scanning line, and at points 1 m distant from the CT scanning line within the CT room, were measured during CT scanning using an electric-field measuring device (FD-1, Combinova, Sweden) and a magnetic-field measuring device (Model 5080, F.W. Bell, Orlando, FL, USA). The measurements were repeated 3 times, and the maximum values were adopted. Effects of CT Scanning on Pacemaker Function in Human Body ModelsThe pacemakers, Thera SR8960i and Kappa SR701 (Medtronic, Minneapolis, MN, USA), combined with a 5024M lead (Medtronic) were mounted in Irnich's human body model (Fig 1) 8-10 and subjected to CT scanning. The bench model (Fig 2) was constructed for this study to clarify the conditions induced by CT scanning that might influence pacemaker function.Measuring Systems The Irnich's body model was filled with 0.18 w-% saline, and the electroconductivity of the model was set at a value equivalent to that of the human body. Pick-up electrodes to receive pacing pulses from the pacemaker were attached to the pacemaker lead. Specific electrodes to input the sensing signals (known as cenelic patterns) produced by the pseudo-beat generator were also arranged on the model. The model was connected to the pseudo-beat generator and recorder via a 20-m cable that Circ J 2006; 70: 190 -197 (Received August 24, 2005; revised manuscrip...

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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%