Cardiovascular magnetic resonance at 3-tesla (3T) has inherent technical challenges that are increasingly being overcome. Recently, some pacemakers and leads have been approved for 3T conditional use. The purpose of this report is to review B1+RMS, a new, more accurate parameter used to define energy deposition during magnetic resonance imaging, as well as to present the imaging protocol and procedure utilized to rule out causes of heart block in a patient with a pacemaker in-situ. This case demonstrates that high quality, diagnostic images can be obtained at 3T with conditional pacemakers in situ.

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