Preclinical evaluation of implantable cardioverter-defibrillator developed for magnetic resonance imaging use.

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State: Public
Version: author
Serval ID
serval:BIB_34C68D276F85
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Preclinical evaluation of implantable cardioverter-defibrillator developed for magnetic resonance imaging use.
Journal
Heart Rhythm
Author(s)
Gold M.R., Kanal E., Schwitter J., Sommer T., Yoon H., Ellingson M., Landborg L., Bratten T.
ISSN
1556-3871 (Electronic)
ISSN-L
1547-5271
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
12
Number
3
Pages
631-638
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND: Many patients with an implantable cardioverter-defibrillator (ICD) have indications for magnetic resonance imaging (MRI). However, MRI is generally contraindicated in ICD patients because of potential risks from hazardous interactions between the MRI and ICD system.
OBJECTIVE: The purpose of this study was to use preclinical computer modeling, animal studies, and bench and scanner testing to demonstrate the safety of an ICD system developed for 1.5-T whole-body MRI.
METHODS: MRI hazards were assessed and mitigated using multiple approaches: design decisions to increase safety and reliability, modeling and simulation to quantify clinical MRI exposure levels, animal studies to quantify the physiologic effects of MRI exposure, and bench testing to evaluate safety margin.
RESULTS: Modeling estimated the incidence of a chronic change in pacing capture threshold >0.5V and 1.0V to be less than 1 in 160,000 and less than 1 in 1,000,000 cases, respectively. Modeling also estimated the incidence of unintended cardiac stimulation to occur in less than 1 in 1,000,000 cases. Animal studies demonstrated no delay in ventricular fibrillation detection and no reduction in ventricular fibrillation amplitude at clinical MRI exposure levels, even with multiple exposures. Bench and scanner testing demonstrated performance and safety against all other MRI-induced hazards.
CONCLUSION: A preclinical strategy that includes comprehensive computer modeling, animal studies, and bench and scanner testing predicts that an ICD system developed for the magnetic resonance environment is safe and poses very low risks when exposed to 1.5-T normal operating mode whole-body MRI.
Pubmed
Web of science
Create date
26/03/2015 19:22
Last modification date
20/08/2019 14:21
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