Journal article
High-energy external defibrillation and transcutaneous pacing during MRI: feasibility and safety
Journal of cardiovascular magnetic resonance, Vol.21(1), pp.47-47
08/05/2019
DOI: 10.1186/s12968-019-0558-z
PMCID: PMC6681494
PMID: 31378203
Abstract
Background Rapid application of external defibrillation, a crucial first-line therapy for ventricular fibrillation and cardiac arrest, is currently unavailable in the setting of magnetic resonance imaging (MRI), raising concerns about patient safety during MRI tests and MRI-guided procedures, particularly in patients with cardiovascular diseases. The objective of this study was to examine the feasibility and safety of defibrillation/pacing for the entire range of clinically useful shock energies inside the MRI bore and during scans, using defibrillation/pacing outside the magnet as a control. Methods Experiments were conducted using a commercial defibrillator (LIFEPAK 20, Physio-Control, Redmond, Washington, USA) with a custom high-voltage, twisted-pair cable with two mounted resonant floating radiofrequency traps to reduce emission from the defibrillator and the MRI scanner. A total of 18 high-energy (200-360 J) defibrillation experiments were conducted in six swine on a 1.5 T MRI scanner outside the magnet bore, inside the bore, and during scanning, using adult and pediatric defibrillation pads. Defibrillation was followed by cardiac pacing (with capture) in a subset of two animals. Monitored signals included: high-fidelity temperature (0.01 degrees C, 10 samples/sec) under the pads and 12-lead electrocardiogram (ECG) using an MRI-compatible ECG system. Results Defibrillation/pacing was successful in all experiments. Temperature was higher during defibrillation inside the bore and during scanning compared with outside the bore, but the differences were small (Delta T: 0.5 and 0.7 degrees C, p = 0.01 and 0.04, respectively). During scans, temperature after defibrillation tended to be higher for pediatric vs. adult pads (p = 0.08). MR-image quality (signal-to-noise ratio) decreased by similar to 10% when the defibrillator was turned on. Conclusions Our study demonstrates the feasibility and safety of in-bore defibrillation for the full range of defibrillation energies used in clinical practice, as well as of transcutaneous cardiac pacing inside the MRI bore. Methods for Improving MR-image quality in the presence of a working defibrillator require further study.
Details
- Title: Subtitle
- High-energy external defibrillation and transcutaneous pacing during MRI: feasibility and safety
- Creators
- Vladimir Shusterman - University of IowaDenice Hodgson-Zingman - University of IowaDaniel Thedens - University of IowaXiaodong Zhu - University of IowaStacy Hoffman - PinMedJessica C. Sieren - University of IowaGina M. Morgan - University of IowaAnthony Faranesh - National Heart Lung and Blood InstituteBarry London - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular magnetic resonance, Vol.21(1), pp.47-47
- DOI
- 10.1186/s12968-019-0558-z
- PMID
- 31378203
- PMCID
- PMC6681494
- NLM abbreviation
- J Cardiovasc Magn Reson
- ISSN
- 1097-6647
- eISSN
- 1532-429X
- Publisher
- Springer Nature
- Number of pages
- 14
- Grant note
- DP1 OD003819 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA HHSN268201500009C / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA P30ES005605 / NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Environmental Health Sciences (NIEHS)
- Language
- English
- Date published
- 08/05/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Molecular Physiology and Biophysics; Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984297510202771
Metrics
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