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Magnetic resonance imaging in patients with cardiac implanted electronic devices: focus on contraindications to magnetic resonance imaging protocols. Europace 2017 May 01;19(5):812-817

Date

06/04/2016

Pubmed ID

27256419

DOI

10.1093/europace/euw122

Scopus ID

2-s2.0-85027401665   48 Citations

Abstract

AIMS: Magnetic resonance imaging (MRI) has been reported to be safe in patients with cardiac implantable electronic devices (CIED) provided a specific protocol is followed. The objective of this study was to assess whether this is also true for patients excluded from published protocols.

METHODS AND RESULTS: A total of 160 MRIs were obtained in 142 consecutive patients with CIEDs [106 patients had an implantable cardioverter defibrillator (ICD) and 36 had a pacemaker implanted] using an adapted, pre-specified protocol. A cardiac MRI was performed in 95 patients, and a spinal/brain MRI was performed in 47 patients. Forty-six patients (32%) had either abandoned leads (n = 10), and/or were pacemaker dependent with an implanted ICD (n = 19), had recently implanted CIEDs (n = 1), and/or had a CIED device with battery depletion (n = 2), and/or a component of the CIED was recalled or on advisory (n = 32). No major complications occurred. Some device parameters changed slightly, but significantly, right after or at 1-week post-MRI without requiring any reprogramming. In one patient with an ICD on advisory, the pacing rate changed inexplicably during one of his two MRIs from 90 to 50 b.p.m.

CONCLUSION: Using a pre-specified protocol, cardiac and non-cardiac MRIs were performed in CIED patients with pacemaker dependency, abandoned leads, or depleted batteries without occurrence of major adverse events. Patients with devices on advisory need to be monitored carefully during MRI, especially if they are pacemaker dependent.

Author List

Horwood L, Attili A, Luba F, Ibrahim EH, Parmar H, Stojanovska J, Gadoth-Goodman S, Fette C, Oral H, Bogun F

Author

El-Sayed H. Ibrahim PhD Associate Professor in the Radiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Burns, Electric
Contraindications
Defibrillators, Implantable
Equipment Failure
Female
Foreign-Body Reaction
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pacemaker, Artificial
Reproducibility of Results
Sensitivity and Specificity