title: Compatibility of temporary pacemaker myocardial pacing leads with magnetic resonance imaging: an ex vivo tissue study.
abstract: The presence of temporary myocardial pacing leads is considered a safety contraindication for magnetic resonance imaging (MRI). The aim of this ex vivo tissue study was to measure the heating effects at the tip of the leads using proton magnetic resonance spectroscopy ((1)HMRS) thermometry. The tissue effects were verified by histological analyses. Pig hearts with implanted temporary pacemaker myocardial pacing leads were examined by whole-body MRI at 1.5 Tesla. The tests were performed either by a sequence with high specific absorption rate (SAR) or by standard clinical sequences with lower SAR. Temperature changes were detected via (1)HMRS thermometry, by monitoring the frequency difference between water protons and the reference signals of N-methyl protons of creatine/phosphocreatine (Cr/PCr) and trimethylamine (TMA). Histology was performed using several staining techniques. Standard low-SAR and high-SAR sequences did not cause significant temperature increases in the myocardial tissue surrounding the implanted leads. There were no histopathological signs of thermal damage around the tips of the leads in any of the hearts or in a control implanted heart not subjected to MRI. The present data suggest that temporary pacemaker myocardial pacing leads may be compatible with MR scanning at 1.5 Tesla. However, further in vivo studies and carefully monitored patient studies are needed before final safety recommendations can be made.
authors.affiliation: Department of Internal Medicine III, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747 Jena, Germany. alexander.pfeil@med.uni-jena.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Pfeil
authors.forename: Stefanie
authors.initials: S
authors.lastname: Drobnik
authors.forename: Reinhard
authors.initials: R
authors.lastname: Rzanny
authors.forename: Anas
authors.initials: A
authors.lastname: Aboud
authors.forename: Joachim
authors.initials: J
authors.lastname: Böttcher
authors.forename: Peter
authors.initials: P
authors.lastname: Schmidt
authors.forename: Christian
authors.initials: C
authors.lastname: Ortmann
authors.forename: Gita
authors.initials: G
authors.lastname: Mall
authors.forename: Khosro
authors.initials: K
authors.lastname: Hekmat
authors.forename: Bernhard
authors.initials: B
authors.lastname: Brehm
authors.forename: Juergen
authors.initials: J
authors.lastname: Reichenbach
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Mayer
authors.forename: Gunter
authors.initials: G
authors.lastname: Wolf
authors.forename: Andreas
authors.initials: A
authors.lastname: Hansch
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004867:Equipment Design; D005240:Feasibility Studies; D006358:Hot Temperature; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D009682:Magnetic Resonance Spectroscopy; D008744:Methylamines / Q000378:metabolism; D023421:Models, Animal; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D010138:Pacemaker, Artificial / Q000009:adverse effects; D010725:Phosphocreatine / Q000378:metabolism; D018570:Risk Assessment; D013194:Staining and Labeling; D013552:Swine
chemical_list: D015415:Biomarkers; D008744:Methylamines; D010725:Phosphocreatine; C023336:trimethylamine; D003401:Creatine