The Safety of Cardiac and Thoracic Magnetic Resonance Imaging in Patients with Cardiac Implantable Electronic Devices

Sanjay Dandamudi, Jeremy D. Collins, James C. Carr, Pat Mongkolwat, Amir A. Rahsepar, Todd T. Tomson, Nishant Verma, Rishi Arora, Alex B. Chicos, Susan S. Kim, Albert C. Lin, Rod S. Passman, Bradley P. Knight*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Rationale and Objectives Studies reporting the safety of magnetic resonance imaging (MRI) in patients with a cardiac implantable electronic device (CIED) have mostly excluded examinations with the device in the magnet isocenter. The purpose of this study was to describe the safety of cardiac and thoracic spine MRI in patients with a CIED. Materials and Methods The medical records of patients with a CIED who underwent a cardiac or thoracic spine MRI between January 2011 and December 2014 were reviewed. Devices were interrogated before and after imaging with reprogramming to asynchronous pacing in pacemaker-dependent patients. The clinical interpretability of the MRI and peak and average specific absorption rates (SARs, W/kg) achieved were determined. Results Fifty-eight patients underwent 51 cardiac and 11 thoracic spine MRI exams. Twenty-nine patients had a pacemaker and 29 had an implantable cardioverter defibrillator. Seventeen percent (n = 10) were pacemaker dependent. Fifty-one patients (89%) had non-MRI-conditional devices. There were no clinically significant changes in atrial and ventricular sensing, impedance, and threshold measurements. There were no episodes of device mode changes, arrhythmias, therapies delivered, electrical reset, or battery depletion. One study was prematurely discontinued due to a patient complaint of chest pain of which the etiology was not determined. Across all examinations, the average peak SAR was 2.0 ± 0.85 W/kg with an average SAR of 0.35 ± 0.37 W/kg. Artifact significantly limiting the clinical interpretation of the study was present in 33% of cardiac MRI studies. Conclusions When a comprehensive CIED magnetic resonance safety protocol is followed, the risk of performing 1.5-T magnetic resonance studies with the device in the magnet isocenter, including in patients who are pacemaker dependent, is low.

Original languageEnglish (US)
Pages (from-to)1498-1505
Number of pages8
JournalAcademic radiology
Volume23
Issue number12
DOIs
StatePublished - Dec 1 2016

Keywords

  • Cardiac implantable electronic device
  • adverse effects
  • artifact
  • isocenter
  • magnetic resonance imaging
  • safety
  • specific absorption rate

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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