Vertical MRI systems may offer a safer platform with substantially reduced RF heating in adult and pediatric patients with CIEDs

MRI is restricted for patients with cardiac implantable electronic devices (CIEDs)—especially children with epicardial systems—due to potential radiofrequency (RF) heating of the tissue around the lead. Here, we present the first assessment of RF heating of epicardial and endocardial CIEDs with varying lead lengths in a vertical MRI system, where we found up to a 78-fold reduction in the simulated maximum specific absorption rate (SAR) compared to a horizontal coil. Reduction in the maximum 0.1g-averaged SAR in the vertical coil was consistent for leads with various internal wire geometries and electrical lengths.