RF-induced heating of capped and uncapped abandoned epicardial leads during MRI at 1.5 T and 3 T.

There is a paucity of data regarding the safety of magnetic resonance imaging (MRI) in patients with abandoned epicardial leads. Few studies have reported temperature rises up to 76 °C during MRI at 1.5 T in gel phantoms implanted with epicardial leads; however, lead trajectories used in these experiments were not clinically relevant.

Variations in Determining Actual Orientations of Segmented Deep Brain Stimulation Leads Using the DiODe Algorithm: A Retrospective Study Across Different Lead Designs and Medical Institutions.

Introduction: Directional deep brain stimulation (DBS) leads have become widely used in the past decade. Understanding the asymmetric stimulation provided by directional leads requires precise knowledge of the exact orientation of the lead in respect to its anatomical target. Recently, the DiODe algorithm was developed to automatically determine the orientation angle of leads from the artifact on postoperative computed tomography (CT) images.

Age Matters: A Comparative Study of RF Heating of Epicardial and Endocardial Electronic Devices in Pediatric and Adult Phantoms during Cardiothoracic MRI.

This study focused on the potential risks of radiofrequency-induced heating of cardiac implantable electronic devices (CIEDs) in children and adults with epicardial and endocardial leads of varying lengths during cardiothoracic MRI scans. Infants and young children are the primary recipients of epicardial CIEDs, though the devices have not been approved as MR conditional by the FDA due to limited data, leading to pediatric hospitals either refusing the MRI service to most pediatric CIED patients or adopting a scan-all strategy based on results from adult studies. The study argues that risk-benefit decisions should be made on an individual basis.

Artifacts Can Be Deceiving: The Actual Location of Deep Brain Stimulation Electrodes Differs from the Artifact Seen on Magnetic Resonance Images.

Introduction: Deep brain stimulation (DBS) is a common treatment for a variety of neurological and psychiatric disorders. Recent studies have highlighted the role of neuroimaging in localizing the position of electrode contacts relative to target brain areas in order to optimize DBS programming. Among different imaging methods, postoperative magnetic resonance imaging (MRI) has been widely used for DBS electrode localization; however, the geometrical distortion induced by the lead limits its accuracy.

True location of deep brain stimulation electrodes differs from what is seen on postoperative magnetic resonance images: An anthropomorphic phantom study.

Deep brain stimulation (DBS) is an established yet growing treatment for a range of neurological and psychiatric disorders. Over the last decade, numerous studies have underscored the effect of electrode placement on the clinical outcome of DBS. As a result, imaging is now extensively used for DBS electrode localization, even though the accuracy of different modalities in determining the true coordinates of DBS electrodes is less explored.

Analysis of the intended and actual orientations of directional deep brain stimulation leads across deep brain stimulation systems.

Deep brain stimulation (DBS) offers therapeutic benefits to patients suffering from a variety of treatment-resistant neurological and psychiatric disorders. The newest generation of DBS devices now offer directional leads, which utilize segmented electrodes to direct current asymmetrically to the neuronal tissue. Since segmented electrodes offer a larger degree of freedom for contact positioning, it is critical to assess how well the surgically intended and the actual orientation of the lead match to facilitate programming and allow appropriate interpretation of the therapeutic outcome.

Critical Information from High Fidelity Arterial and Venous Pressure Waveforms During Anesthesia and Hemorrhage.

Purpose: Peripheral venous pressure (PVP) waveform analysis is a novel, minimally invasive, and inexpensive method of measuring intravascular volume changes. A porcine cohort was studied to determine how venous and arterial pressure waveforms change due to inhaled and infused anesthetics and acute hemorrhage.

Methods: Venous and arterial pressure waveforms were continuously collected, while each pig was under general anesthesia, by inserting Millar catheters into a neighboring peripheral artery and vein.

Anesthetics affect peripheral venous pressure waveforms and the cross-talk with arterial pressure.

Analysis of peripheral venous pressure (PVP) waveforms is a novel method of monitoring intravascular volume. Two pediatric cohorts were studied to test the effect of anesthetic agents on the PVP waveform and cross-talk between peripheral veins and arteries: (1) dehydration setting in a pyloromyotomy using the infused anesthetic propofol and (2) hemorrhage setting during elective surgery for craniosynostosis with the inhaled anesthetic isoflurane. PVP waveforms were collected from 39 patients that received propofol and 9 that received isoflurane.