Age and lead configuration matter: A comparative study of RF-induced heating of epicardial and endocardial electronic devices in adult and pediatric anthropomorphic phantoms in 1.5 T MR

• DOI: 10.1101/2022.11.03.515092
• Publication Date: 2022-11-05T06:30:17Z
• Authors: Fuchang Jiang; Kaylee R. Henry; Bhumi Bhusal; Pia Sanpitak; Gregory Webster; Andrada Popescu; Giorgio Bonmassar; Christina Laternser; Daniel Kim; Laleh Golestanirad
• Keywords: Lead (geology)

Abstract Background Children with congenital heart defects often have life-sustaining indications for a cardiac implantable electronic device (CIED). In children, these devices are typically sewn to the epicardium, but FDA has never licensed an epicardial system as MR-Conditional due limited data. Children’s hospitals default either refusing MRI service vast majority of pediatric CIED patients or adopting scan-all strategy based on results from adult studies. We argue that both approaches flawed, and risk-benefit decisions should be made individual basis. Purpose To provide evidence-based knowledge RF-induced heating CIEDs in children adults endocardial leads different lengths. Study Type Phantom Field Strength/Sequence 1.5 T. Assessment 120 clinically relevant configurations were implemented anthropomorphic phantoms. Temperature rise was recorded during RF exposure at Statistical Tests Means comparisons using two-sample t-tests, reliability analysis interclass correlation coefficient single rating, absolute-agreement, 2-way mixed-effects model. Results There significantly higher compared phantom (3.4 ± 3.0 vs. 0.6 0.4 °C, p<0.001); however, there no significant difference (3.0 3.2 2.0 1.8, p=0.16). Endocardial generated less than (0.6 °C 1.8 p<0.001). Data Conclusion Body size lead length affected heating. For models younger short (e.g., 25cm), up 12 observed, delivering cumulative thermal dose previously associated tissue necrosis. contrast, model well below expected physiologic fever (3 °C).