Abstract 16181: Impact of Magnetic Resonance Imaging on Functional Integrity of Non-conditional Cardiovascular Implantable Electronic Devices

Abstract

Introduction: Magnetic Resonance Imaging (MRI) non-conditional cardiovascular implantable electronic devices (CIEDs) have historically restricted the use of MRI. We investigated the impact of MRI on the functional integrity of CIEDs. Methods: In this prospective, observational single-center study, we enrolled patients undergoing MRI over a 5-year period. Prior to assessing the impact of MRI on CIED integrity, we performed interrogations in sequential duplication to assess the intrinsic variability of the device. Subsequently, we performed interrogations immediately after MRI and monitored changes in device parameters and clinical events. Results: We completed 492 MRI studies, 283 (58%) in patients with permanent pacemakers (PPMs), and 209 (42%) with implantable cardioverter defibrillators (ICDs). Subsequent MRI exposures occurred in 73 of 492 (15%) encounters. Accounting for intrinsic variability in CIED lead parameters, there were no significant changes in RA, RV, or LV lead parameters after MRI, regardless of the region of scan (thoracic vs non-thoracic), type of CIED (PPMs vs ICDs) and among those with serial MRIs. When ranked for % change pre- to post-MRI, the majority of RA, RV, and LV metrics for thresholds, sensing, and impedance conformed to ≤20% change. No significant clinical adverse cardiac events or effect on device microcircuitry occurred during the study. Conclusion: Incorporating a novel reproducibility tactic, there were no clinically meaningful device parameter changes nor were there adverse clinical events during or following MRIs, suggesting the effects of MRI on non-conditional CIED integrity are far less than previously perceived.