Effects of CT irradiation on implantable cardiac rhythm management devices

Cynthia H McCollough, Jie Zhang, Andrew N. Primak, Wesley J. Clement, John R. Buysman

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: To prospectively measure the response of a variety of models of implantable cardiac rhythm management devices (ICRMDs) to the radiation delivered by computed tomography (CT), for both maximum and typical dose levels. Materials and Methods: Twenty-one ICRMDs (13 pacemakers, eight cardioverter-defibrillators) manufactured by Medtronic (Minneapolis, Minn) were exposed to ionizing radiation from CT systems in both spiral and dynamic acquisition modes at maximum and typical dose levels. Devices were monitored during exposure to check for any operational abnormalities and were interrogated after exposure to check for any residual abnormalities. Total radiation dose and peak dose rate were measured, and the volume CT dose index was recorded. Results: Oversensing was observed in 20 of 21 devices at maximum doses and in 17 of 20 devices at typical doses. Oversensing most often manifested as inhibition, although it occasionally manifested as tracking or safety pacing. Two devices inhibited for more than 4 seconds in spiral mode at clinical dose levels. Oversensing was transient and ceased as soon as the device stopped moving through the x-ray beam or the beam was turned off. The partial electrical reset (PER) safety feature was activated in two models, InSync 8040 and Thera DR. With the exception of PER, programming was not altered. Effects occurred only if the x-ray beam passed directly over the ICRMD. Conclusion: CT irradiation at typical clinical doses results in oversensing of ICRMDs in the majority of devices tested, although the identified effects were predominantly transient.

Original languageEnglish (US)
Pages (from-to)766-774
Number of pages9
JournalRadiology
Volume243
Issue number3
DOIs
StatePublished - Jun 2007

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Tomography
Equipment and Supplies
X-Rays
Radiation
Safety
Cone-Beam Computed Tomography
Defibrillators
Ionizing Radiation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Effects of CT irradiation on implantable cardiac rhythm management devices. / McCollough, Cynthia H; Zhang, Jie; Primak, Andrew N.; Clement, Wesley J.; Buysman, John R.

In: Radiology, Vol. 243, No. 3, 06.2007, p. 766-774.

Research output: Contribution to journalArticle

McCollough, CH, Zhang, J, Primak, AN, Clement, WJ & Buysman, JR 2007, 'Effects of CT irradiation on implantable cardiac rhythm management devices', Radiology, vol. 243, no. 3, pp. 766-774. https://doi.org/10.1148/radiol.2433060993
McCollough, Cynthia H ; Zhang, Jie ; Primak, Andrew N. ; Clement, Wesley J. ; Buysman, John R. / Effects of CT irradiation on implantable cardiac rhythm management devices. In: Radiology. 2007 ; Vol. 243, No. 3. pp. 766-774.
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