2021 Update on Safety of Magnetic Resonance Imaging: Joint Statement From Canadian Cardiovascular Society/Canadian Society for Cardiovascular Magnetic Resonance/Canadian Heart Rhythm Society

Abstract

Magnetic resonance imaging (MRI) is often considered the goldstandard test for characterizing cardiac as well as noncardiac structure and function. However, many patients with cardiac implantable electronic devices (CIEDs) and/or severe renal dysfunction are unable to undergo this test because of safety concerns. In the past 10 years, newer-generation CIEDs and gadolinium-based contrast agents (GBCAs) as well as coordinated care between imaging and heart rhythm device teams have mitigated risk to patients and improved

Deep Learning Analysis of Cardiac MRI in Legacy Datasets: Multi-Ethnic Study of Atherosclerosis

“…Although this study specifically trained deep learning networks for old legacy gradient echo (GRE) cine images, there are some clinical applications employing GRE imaging. In a recent guideline (34), the image quality of GRE images is better than that of the current steady-state free precession (SSFP) cine images for patients with cardiac implantable electronic devices (35). GRE images are also preferred for T1 and T2weighted images particularly for patients with suspected iron overload (36).…”

Remote programming of cardiac implantable electronic devices for MRI: Are we ready to change the channel?

“…Given these factors, it is predicted that 75% of patients with a CIED will need an MRI during their lifetime 2 . With improvement in safety protocols, MRI in patients with CIEDs with either conditional or nonconditional systems is considered safe 1–4 . However, with improvements in remote monitoring capabilities for CIEDs, there has been a recent desire to expand into remote programming (Table 2).…”

“…An inhibiting (VVI/DDI) mode can also be chosen if the patient is nondependent. However, our preference has been to avoid this mode due to the risk of inappropriate sensing, which has been previously described 4 . Asynchronous pacing rates are programmed faster than the underlying rate to avoid competitive pacing.…”

“…2 With improvement in safety protocols, MRI in patients with CIEDs with either conditional or nonconditional systems is considered safe. [1][2][3][4] However, with improvements in remote monitoring capabilities for CIEDs, there has been a recent desire to expand into remote programming (Table 2). The six primary CIED companies each have a remote monitoring platform.…”

Stress Perfusion Cardiac Magnetic Resonance Imaging With a 3.0-Tesla Scanner for Myocardial Viability in a Patient With a Conditional Pacemaker

“…Growing evidence supports the safety and image quality of cardiac magnetic resonance imaging (CMR) with cardiac implantable electronic devices (CIEDs), but current evidence is limited to 1.5-Tesla (T) scanners and noncardiac 3T studies. 1 , 2 Although 3T scanners have superior diagnostic performance for identifying myocardial ischemia compared to 1.5T scanners, imaging artifacts from CIEDs are also greatest at higher field strengths, limiting their prior use. 3 We present a case of successful stress perfusion (SP)-CMR to determine myocardial viability using a 3T scanner in a patient with a CIED.…”