In vivo finite element model-based image analysis of pacemaker lead mechanics

BACKGROUND Fractures of implanted pacemaker leads are currently identified by inspecting radiographic images without making full use of a priori known material and structural information. Moreover, lead designers are unable to incorporate clinical image data into analyses of lead mechanics. METHODS A novel finite element/active contour method was developed to quantify the in vivo mechanics of implanted leads by estimating the distributions of stress, strain, and traction using biplane videoradiographic images. The nonlinear equilibrium equations governing a thin elastic beam undergoing 3-D large rotation were solved using one-dimensional isoparametric finite elements. External forces based on local image greyscale values were computed from each pair of images using a perspective transformation governing the relationship between the image planes. RESULTS Cantilever beam forward solution results were within 0.2% of the analytic solution for a wide range of applied loads. The finite element/active contour model was able to reproduce the principal curvatures of a synthetic helix within 3% of the analytic solution and estimates of the helix's geometric torsion were within 20% of the analytic solution. Applying the method to biplane videoradiographic images of a lead acutely implanted in an anesthetized dog resulted in expected variations in curvature and bending stress between compliant and rigid segments of the lead. CONCLUSIONS By incorporating knowledge about lead geometric and material properties, the 3-D finite element/active contour method regularizes the image reconstruction problem and allows for more quantitative and automatic assessment of implanted lead mechanics.