Age matters: radiofrequency heating of epicardial and endocardial electronic devices in adults and children varies with body size and lead length

Children with congenital heart defects often have life-sustaining indications for an epicardial cardiac implantable electronic device (CIED). However few data exist on endocardial systems in children. Additionally, the FDA has never approved an epicardial system as MRI-Conditional due to limited data on potential heating risk. To provide evidence-based knowledge on RF-induced heating of CIEDs in children and adults with epicardial and endocardial leads of different lengths, we recorded the temperature increase of 120 clinically relevant trajectories positioned into adult and pediatric phantoms. Our results highlight the need for age and device-specific assessments of MRI safety in children with CIEDs.