Forces on cardiac implantable electronic devices during remote magnetic navigation

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Electrophysiology

Background:

• Remote magnetic navigation systems are utilized for catheter navigation in cardiac electrophysiological ablation.
• The impact of magnetic fields on cardiac implantable electronic devices (CIEDs) during these procedures is not well understood.
• Potential forces exerted on CIEDs must be assessed against the 5 N regulatory limit for implanted electrodes.

Purpose of the Study:

• To investigate the forces exerted on CIEDs by a 0.1 T magnetic field used in remote magnetic navigation.
• To determine if these forces exceed the established safety limits for implanted electrodes.

Main Methods:

• 121 CIEDs (pacemakers and cardioverter-defibrillators) were tested using the NIOBE II Magnetic Navigation System at 0.1 T.
• Forces on the devices were measured using a Futek LRF 400 force measurement tool.
• A standardized protocol involving multi-dimensional magnetic field movements was employed to assess maximal forces.

Main Results:

• Forces on pacemakers averaged 0.33 ± 0.13 N (range 0.16-1.12 N).
• Forces on cardioverter-defibrillators averaged 1.05 ± 0.11 N (range 0.86-1.38 N).
• All measured forces were significantly below the 5 N regulatory limit.

Conclusions:

• Exposure to 0.1 T magnetic fields does not generate forces exceeding the 5 N safety threshold for pacemakers and cardioverter-defibrillators.
• The use of magnetic navigation systems in electrophysiological procedures is unlikely to cause damage to connected CIED leads due to magnetic forces.