Pacemaker and ICD oversensing induced by movements near the MRI scanner bore

E. Mattei, F. Censi, G. Calcagnini, R. Falsaperla, E. Genovese, A. Napolitano, Vittorio Cannatà

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The effect of the movement near the MRI scanner bore for people with a pacemaker (PM) or an implantable cardioverter defbrillator (ICD) is experimentally evaluated and discussed. Methods: The authors performed in vitro measurements on a saline-flled human-shaped phantom (male, 170 cm height), equipped frst with an MR-conditional PM (bicameral confguration, DDD programming), then with an MR-conditional ICD (biventricular confguration, detection algorithms enable but shock delivery disable). Both the devices were able to transmit in real-time the detected cardiac activity (electrograms) while moving the phantom around the MRI scanner. The phantom was also equipped with an accelerometer and a magnetic feld probe to measure the angular velocity and the magnetic feld variation during the experiment. Unipolar versus bipolar sensing mode and maximum sensitivity versus nominal settings were tested. Results: The sensing functions of the PM and ICD systems began to react to motion induced electromagnetic interference starting at an angular velocity as low as 2 rad/s (|dB/dT| = 2 T/s). The motion induced EMI in PM and ICD systems was interpreted as sensed intrinsic heartbeats which resulted in inappropriate pacing inhibition and arrhythmia classifcation. At the maximum speed of about 6 rad/s (|dB/dT| = 3 T/s), the induced EMI affected classifcation of ectopic beats and two episodes of VF were inappropriately recorded. Conclusions: These results demonstrate that motion in and around an MR scanner can induce EMI signifcant enough to be misinterpreted by implanted PMs and ICDs leading to inappropriate changes in therapy. These fndings highlight that PM or ICDs, including MR-conditional systems should not enter the MRI room, except in case of an examination under specifed conditions.

Original languageEnglish
Pages (from-to)6621-6631
Number of pages11
JournalMedical Physics
Volume43
Issue number12
DOIs
Publication statusPublished - Dec 1 2016

Keywords

  • implantable defibrillator
  • magnetic resonance imaging
  • movement in static field
  • occupational exposure
  • pacemaker

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging

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