Key result
Simulated MRI fields do not trigger serious arrhythmias in healthy patients but elevate risk in cardiac disease.
Why the study?
Strong, time-varying gradient magnetic fields in MRI may induce electric fields in thoracic tissues that could influence cardiac electric activity, especially in diseased hearts.
Do magnetically-induced E-fields during MRI elicit cardiac arrhythmias in healthy or diseased hearts?
Do magnetically-induced E-fields during MRI elicit cardiac arrhythmias in healthy or diseased hearts?
Computational modeling suggests that while contemporary MRI gradient sets are safe for healthy hearts, higher gradient strengths or pre-existing cardiac disease may increase the risk of induced arrhythmias.
Modeling of MRI gradient E-fields in thorax is hypothesis-generating; leaves open need for empirical cardiac stimulation data before safety guideline updates.
In modern magnetic resonance imaging (MRI), patients are exposed to strong, time-varying gradient magnetic fields that may be able to induce electric fields (E-fields)/currents in tissues approaching the level of physiological significance. In this work we present theoretical investigations into induced E-fields in the thorax, and evaluate their potential influence on cardiac electric activity under the assumption that the sites of maximum E-field correspond to the myocardial stimulation threshold (an abnormal circumstance). Whole-body cylindrical and planar gradient coils were included in the model. The calculations of the induced fields are based on an efficient, quasi-static, finite-difference scheme and an anatomically realistic, whole-body model. The potential for cardiac stimulation was evaluated using an electrical model of the heart. Twelve-lead electrocardiogram (ECG) signals were simulated and inspected for arrhythmias caused by the applied fields for both healthy and diseased hearts. The simulations show that the shape of the thorax and the conductive paths significantly influence induced E-fields. In healthy patients, these fields are not sufficient to elicit serious arrhythmias with the use of contemporary gradient sets. However, raising the strength and number of repeated switching episodes of gradients, as is certainly possible in local chest gradient sets, could expose patients to increased risk. For patients with cardiac disease, the risk factors are elevated. By the use of this model, the sensitivity of cardiac pathologies, such as abnormal conductive pathways, to the induced fields generated by an MRI sequence can be investigated.
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Liu et al. (2003) studied Cardiac electric activity during MRI. Magnetically-induced E-fields during MRI was evaluated on Cardiac stimulation and arrhythmias. Simulations of magnetically-induced E-fields during MRI showed they do not elicit serious arrhythmias in healthy patients with contemporary gradient sets, but risk is elevated in cardiac disease.
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