AI Article Synopsis
- The study explores the safety of conducting MRI scans in patients with cardiac implants like pacemakers and ICDs, which are typically seen as contraindications for such procedures.
- Over nine years, 65 patients underwent 73 MRI exams, with precautions taken like reprogramming devices to prevent issues during scans.
- Results showed that while most MRIs were safe, there were rare instances of device inhibition and induction of complications, especially in ICD patients, indicating that MRI remains experimental for them.
Article Abstract
Introduction: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need for MRI examination.
Material And Methods: During a period of nine years we have included 65 patients with cardiac devices (60 pacemakers and five ICDs) who underwent a total of 73 MRI examinations at 1.5 T. All pacemakers were reprogrammed before MRI to asynchronous mode to avoid MRI-induced inhibition or to sense only mode to avoid MRI-induced competitive pacing and potential pro-arrhythmia. All devices were interrogated immediately before and after the MRI examination, which included measurement of sensitivity, pacing capture threshold (PCT) and lead impedance.
Results: MRI examinations were completed safely in 63 patients. Inhibition of pacemaker output was observed in one patient and induction of ventricular fibrillation was observed in another with ICD. A significant increase in PCT was rare and only detected in 1% of all electrodes.
Conclusion: MRI can be performed safely in patients with pacemakers with an acceptable risk-benefit ratio, while MRI of patients with ICDs must still be considered an experimental procedure.
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