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Compatibility of temporary pacemaker myocardial pacing leads with magnetic resonance imaging: an ex vivo tissue study

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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 (1HMRS) 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 1HMRS 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.

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Abbreviations

1HMRS:

Proton magnetic resonance spectroscopy

Cr/PCr:

Creatine/phosphocreatine

EPI:

Echo planar imaging

FLAIR:

Fluid-attenuated inversion recovery

HLSVD:

Hankel Lanczos squares singular values decomposition

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

Ppm:

Parts per million

SAR:

Specific absorption rate

TMA:

Trimethylamine

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Acknowledgments

The authors thank Dr. Nicola M. Osypka (managing and sales director, Dr. Osypka GmbH, Germany) for the use of the temporary pacemaker myocardial pacing leads; Rüdiger Vollandt, PhD, for statistical advice; and Dr. Ernesta Palombo-Kinne for critical revision of the manuscript.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Internal Medicine III, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Alexander Pfeil & Gunter Wolf

  2. Institute of Legal Medicine, Friedrich-Schiller-University Jena, Fürstengraben 23, 07747, Jena, Germany

    Stefanie Drobnik, Christian Ortmann & Gita Mall

  3. Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Reinhard Rzanny & Juergen Reichenbach

  4. Department of Cardiothoracic Surgery, Herzzentrum Nordrheinwestfalen, Bad Oeynhausen, Germany

    Anas Aboud

  5. Institute of Diagnostic and Interventional Radiology, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548, Gera, Germany

    Joachim Böttcher

  6. Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Khosro Hekmat

  7. Department of Internal Medicine I, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Bernhard Brehm

  8. Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Peter Schmidt, Thomas E. Mayer & Andreas Hansch

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  1. Alexander Pfeil
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  2. Stefanie Drobnik
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Correspondence to Alexander Pfeil.

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Pfeil, A., Drobnik, S., Rzanny, R. et al. Compatibility of temporary pacemaker myocardial pacing leads with magnetic resonance imaging: an ex vivo tissue study. Int J Cardiovasc Imaging 28, 317–326 (2012). https://doi.org/10.1007/s10554-011-9800-y

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  • DOI: https://doi.org/10.1007/s10554-011-9800-y

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