Comparative Assessment of Rf-Induced Heating in Epicardial Implantable Electronic Devices During 0.55 T and 1.5 T Mri: Effects of Full Systems Vs. Abandoned Leads

Majority of young pediatric patients with cardiac implantable electronic devices (CIEDs) have epicardial leads, creating contraindication for MRI due to concerns about RFinduced heating. This limitation not only denies them access to the superior diagnostic capabilities of MRI but also forces reliance on alternative imaging modalities such as CT and Xray, subjecting young patients to potentially harmful radiation during critical developmental years. While recently introduced low-field MRI scanners (e.g., 0.55 T) are considered more implant-friendly, current claims are based on limited data, and the implant-specific risks remain largely unexplored. In this study, we systematically evaluated the RF heating of a commercial epicardial lead under varying termination conditions during MRI at 0.55 T and compared these results with heating observed at a conventional 1.5 T scanner. Our findings reveal that RF heating of the epicardial lead was significantly lower at 0.55 T across all termination scenarios. Furthermore, leads connected to the implantable pulse generator (IPG) exhibited the highest RF heating, while abandoned leads demonstrated comparatively reduced heating. These results highlight the importance of implant-specific evaluations in assessing MRI safety, particularly at low field strengths, and provide critical insights for optimizing imaging protocols for pediatric CIED patients.