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

Area of Science:

• Medical device engineering
• Biomedical imaging
• Electromagnetism

Background:

• Pacemakers (PM) and implantable cardioverter defibrillators (ICD) are crucial for managing cardiac conditions.
• MRI scanners generate strong magnetic fields and radiofrequency pulses, posing potential risks to implanted electronic devices.

Purpose of the Study:

• To experimentally evaluate the effects of movement near an MRI scanner on MR-conditional pacemakers (PM) and implantable cardioverter defibrillators (ICD).
• To assess the potential for motion-induced electromagnetic interference (EMI) to affect device function and patient safety.

Main Methods:

• In vitro measurements were conducted on a phantom equipped with MR-conditional PM and ICD.
• Phantom movement near the MRI scanner was performed while monitoring device electrograms, angular velocity, and magnetic field variations.
• Sensing modes and sensitivity settings were tested to determine their impact on EMI susceptibility.

Main Results:

• Motion-induced EMI was detected at low angular velocities (2 rad/s), leading to misinterpretation of intrinsic heartbeats.
• Inappropriate pacing inhibition and arrhythmia classification occurred due to EMI.
• At higher speeds (6 rad/s), EMI significantly affected ectopic beat classification and led to inappropriate ventricular fibrillation (VF) recording.

Conclusions:

• Movement in or near an MRI scanner can generate significant EMI, misinterpreted by PMs and ICDs.
• This misinterpretation can lead to inappropriate therapeutic changes, posing risks to patients.
• Even MR-conditional PMs and ICDs should not enter MRI rooms without specific safety protocols.