TY - GEN
T1 - The Position and Orientation of the Pulse Generator Affects MRI RF Heating of Epicardial Leads in Children
AU - Bhusal, Bhumi
AU - Jiang, Fuchang
AU - Kim, Daniel
AU - Hong, Kyung Pyo
AU - Monge, Michael C.
AU - Webster, Gregory
AU - Bonmassar, Giorgio
AU - Golestanirad, Laleh
N1 - Funding Information:
*Research supported by NIH grant R01EB030324. Bhumi Bhusal, KyungPyo Hong and Daniel Kim are with the Department of Radiology, Northwestern University, Chicago, IL 60611 USA. Fuchang Jiang is with the Department of Biomedical Engineering, Northwestern University, Evanston, IL 60608 USA. Gregory Webster and Michael C Monge are with Department of Pediatrics (Cardiology), Feinberg School of Medicine, Chicago, IL 60611 USA.
Publisher Copyright:
© 2022 IEEE.
PY - 2022
Y1 - 2022
N2 - Infants and children with congenital heart defects often receive a cardiac implantable electronic device (CIED). Because transvenous access to the heart is difficult in patients with small veins, the majority of young children receive epicardial CIEDs. Unfortunately, however, once an epicardial CIED is placed, patients are no longer eligible to receive magnetic resonance imaging (MRI) exams due to the unknown risk of MRI-induced radiofrequency (RF) heating of the device. Although many studies have assessed the role of device configuration in RF heating of endocardial CIEDs in adults, such case for epicardial devices in pediatric patients is relatively unexplored. In this study, we evaluated the variation in RF heating of an epicardial lead due to changes in the lateral position and orientation of the implantable pulse generator (IPG). We found that changing the orientation and position of the IPG resulted in a five-fold variation in the RF heating at the lead's tip. Maximum heating was observed when the IPG was moved to a left lateral abdominal position of patient, and minimum heating was observed when the IPG was positioned directly under the heart. Clinical Relevance- This study examines the role of device configuration on MRI-induced RF heating of an epicardial CIED in a pediatric phantom. Results could help pediatric cardiac surgeons to modify device implantation to reduce future risks of MRI in patients.
AB - Infants and children with congenital heart defects often receive a cardiac implantable electronic device (CIED). Because transvenous access to the heart is difficult in patients with small veins, the majority of young children receive epicardial CIEDs. Unfortunately, however, once an epicardial CIED is placed, patients are no longer eligible to receive magnetic resonance imaging (MRI) exams due to the unknown risk of MRI-induced radiofrequency (RF) heating of the device. Although many studies have assessed the role of device configuration in RF heating of endocardial CIEDs in adults, such case for epicardial devices in pediatric patients is relatively unexplored. In this study, we evaluated the variation in RF heating of an epicardial lead due to changes in the lateral position and orientation of the implantable pulse generator (IPG). We found that changing the orientation and position of the IPG resulted in a five-fold variation in the RF heating at the lead's tip. Maximum heating was observed when the IPG was moved to a left lateral abdominal position of patient, and minimum heating was observed when the IPG was positioned directly under the heart. Clinical Relevance- This study examines the role of device configuration on MRI-induced RF heating of an epicardial CIED in a pediatric phantom. Results could help pediatric cardiac surgeons to modify device implantation to reduce future risks of MRI in patients.
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U2 - 10.1109/EMBC48229.2022.9871968
DO - 10.1109/EMBC48229.2022.9871968
M3 - Conference contribution
C2 - 36086119
AN - SCOPUS:85138126851
T3 - Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
SP - 5000
EP - 5003
BT - 44th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2022
PB - Institute of Electrical and Electronics Engineers Inc.
T2 - 44th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2022
Y2 - 11 July 2022 through 15 July 2022
ER -