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

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.