Abstract #1217

Computer-assisted surgical modification of lead trajectory can substantially reduce RF heating of epicardial leads in children during 1.5T MRI

Fuchang Jiang¹, Bhumi Bhusal², Pia Sanpitak², Gregory Webster³, Michael Monge⁴, Giorgio Bonmassar⁵, Daniel Kim², and Laleh Golestanirad^1,2

¹Biomedical Engineering, Northwestern University, Evanston, IL, United States, ²Radiology, Northwestern University, Chicago, IL, United States, ³Division of Cardiology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States, ⁴Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States, ⁵A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States

Synopsis

Keywords: Safety, Safety, epicardial leads;implants

Motivation: Once epicardial CIEDs are implanted in pediatric patients, they pose a relative contraindication for MRI scans due to the increased risk of RF heating.

Goal(s): Enhance MRI safety by reducing RF heating through surgical modification of the lead configuration.

Approach: Mathematical models of the CIED with different lead configurations were developed and validated using the transfer function approach. Low heating trajectories were identified and implemented in a patient.

Results: Placing the excess lead length on the heart’s inferior surface resulted in an average 4-fold reduction in RF heating compared to anterior placement.

Impact: Implementing physics-based surgical modifications to the trajectory of epicardial leads can consistently and significantly reduce RF heating in children undergoing MRI at 1.5T.

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