title: Reducing RF-related heating of cardiac pacemaker leads in MRI: implementation and experimental verification of practical design changes.
abstract: There are serious concerns regarding safety when performing magnetic resonance imaging in patients with implanted conductive medical devices, such as cardiac pacemakers, and associated leads, as severe incidents have occurred in the past. In this study, several approaches for altering an implant's lead design were systematically developed and evaluated to enhance the safety of implanted medical devices in a magnetic resonance imaging environment. The individual impact of each design change on radiofrequency heating was then systematically investigated in functional lead prototypes at 1.5 T. Radiofrequency-induced heating could be successfully reduced by three basic changes in conventional pacemaker lead design: (1) increasing the lead tip area, (2) increasing the lead conductor resistance, and (3) increasing outer lead insulation conductivity. The findings show that radiofrequency energy pickup in magnetic resonance imaging can be reduced and, therefore, patient safety can be improved with dedicated construction changes according to a "safe by design" strategy. Incorporation of the described alterations into implantable medical devices such as pacemaker leads can be used to help achieve favorable risk-benefit-ratios when performing magnetic resonance imaging in the respective patient group.
authors.affiliation: Department of Internal Medicine I-Cardiology, University Hospital Würzburg, Würzburg, Germany. nordbeck_p@medizin.uni-wuerzburg.de
authors.forename: Peter
authors.initials: P
authors.lastname: Nordbeck
authors.forename: Florian
authors.initials: F
authors.lastname: Fidler
authors.forename: Michael T
authors.initials: MT
authors.lastname: Friedrich
authors.forename: Ingo
authors.initials: I
authors.lastname: Weiss
authors.forename: Marcus
authors.initials: M
authors.lastname: Warmuth
authors.forename: Daniel
authors.initials: D
authors.lastname: Gensler
authors.forename: Volker
authors.initials: V
authors.lastname: Herold
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Geistert
authors.forename: Peter M
authors.initials: PM
authors.lastname: Jakob
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.forename: Oliver
authors.initials: O
authors.lastname: Ritter
authors.forename: Mark E
authors.initials: ME
authors.lastname: Ladd
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Bauer
authors.forename: Harald H
authors.initials: HH
authors.lastname: Quick
mesh_terms: D004566:Electrodes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006358:Hot Temperature; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D010138:Pacemaker, Artificial