Safety of serial MRI in patients with implantable cardioverter defibrillators

Abstract

Objective While patients with cardiac implantable electronic devices could benefit from magnetic resonance (MR) imaging, the presence of such devices has been designated as an absolute contraindication to MR. Although scanning algorithms are proposed for cardiac implantable electronic devices, their safety remains uncertain. To address this issue, the safety of serial cardiac MR scans was evaluated in patients with implantable cardioverter defibrillators (ICDs). Methods Three serial cardiac MR scans were prospectively performed at 1.5 T on 10 patients (9 men) of median age 56 years (range 51–68) with ICDs. ICD interrogation was performed before and after the MR scan and at a follow-up of median 370 days (range 274–723). Image quality was also assessed. Results In all patients MR scanning occurred without complications. There were no differences between preand post-MR pacing capture threshold, pacing lead or high voltage lead impedance, or battery voltage values. During follow-up there were no occurrences of ICD dysfunction. Although most patients had image artifacts, the studies were generally diagnostic regarding left ventricular function and wall motion. Delayed enhancement imaging was of good quality for inferior wall and inferolateral infarcts, but ICD artifacts often affected the imaging of anterior wall infarcts. Conclusion Serial MR scans at 1.5 T in patients with ICDs, when carefully performed in a monitored setting, have no adverse effects on either patient or device. When required, single or multiple MR scans at 1.5 T may therefore be considered for clinical diagnostic purposes in these patients.

Safety of Implanted Cardiac Devices in an MRI Environment

“…Additionally, Junttila et al tested the effect of serial scans on ten ICD recipients. Over a period of 12 months, 3 serial MRI caused no adverse reactions and no changes were observed in lead parameters or battery voltage [25].…”

Multicenter study of the safety and effects of magnetic resonance imaging in patients with coronary sinus left ventricular pacing leads

“…The feasibility and safety of MRI scanning in patients with ICDs 3,4,8,9 , abandoned leads 10 , and recent non-CRT device implantation 11 …”

Implantable Devices and Magnetic Resonance Imaging

“…CIEDs are no longer considered an absolute contraindication to MRI [3,35]. However, the decision to proceed with MRI must be carefully thought through on a case-by-case basis, and specific scanning and monitoring conditions are followed, as low risk does not mean no risk.…”