Cardiac magnetic resonance imaging at 1.5 T in patients with cardiac rhythm devices

Buendía, Francisco Javier Escudero; Cano, Óscar; Sánchez-Gómez, Juan Miguel; Igual, Begoña; Osca, Joaquín; Sancho‐Tello, María; Olagüe, José; Salvador, Antonio

doi:10.1093/europace/euq501

Cited by 38 publications

(24 citation statements)

References 35 publications

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“…SAR max and total scan duration showed no significant difference compared to patients without 100% PCT increase. The missing association between SAR and changes in lead specific parameters in our study is in line with previously published in vivo data [5,23,24]. …”

Section: Discussionsupporting

confidence: 93%

Safe performance of magnetic resonance of the heart in patients with magnetic resonance conditional pacemaker systems: the safety issue of the ESTIMATE study

Wollmann

Thudt

Kaiser

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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BackgroundNo published data exist about the safety of diagnostic magnetic resonance (MR) of the heart performed in a larger series of patients implanted with MR conditional pacemakers (PM). The purpose of our study is to analyse safety and potential alterations of electrical lead parameters in patients implanted with the EnRhythm/Advisa MRI SureScan PM with 5086MRI leads (Medtronic Inc.) during and after MR of the heart at 1.5 Tesla.MethodsPatients enrolled in this single center pilot study who underwent non-clinically indicated diagnostic MR of the heart were included in this analysis. Heart MR was performed for analyses of potential changes in right and left ventricular functional parameters under right ventricular pacing at 80 and 110 bpm. Atrial/ventricular sensing, atrial/ventricular pacing capture threshold [PCT], and pacing impedances were assessed immediately before, during, and immediately after MR, as well at 3 and 15 months post MR.ResultsThirty-six patients (mean age 69 ± 13 years; high degree AV block 18 [50%]) underwent MR of the heart. No MR related adverse events occurred during MR or thereafter. Ventricular sensing differed significantly between the FU immediately after MR (10.3 ± 5.3 mV) and the baseline FU (9.8 ± 5.3 mV; p < 0.05). Despite PCT [V/0.4ms] was not significantly different between the FUs (baseline: 0.84 ± 0.27; in-between MR scans: 0.82 ± 0.27; immediately after MR: 0.84 ± 0.24; 3-month: 0.85 ± 0.23; 15-month: 0.90 ± 0.67; p = ns), 7 patients (19%) showed PCT increases by 100% (max. PCT measured: 1.0 V) at the 3-month FU compared to baseline. RV pacing impedance [Ω/5V] differed significantly at the FU in-between MR scans (516 ± 47), and at the 15-month FU (482 ± 58) compared to baseline (508 ± 75).ConclusionThe results of our study suggest MR of the heart to be safe in patients with the MR conditional EnRhythm/Advisa system, albeit although noticeable but clinically irrelevant ventricular PCT changes were observed.

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Section: Discussionsupporting

confidence: 93%

Safe performance of magnetic resonance of the heart in patients with magnetic resonance conditional pacemaker systems: the safety issue of the ESTIMATE study

Wollmann

Thudt

Kaiser

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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“…Recent developments in implantable cardiac devices have led to an increasing number of pacemaker patients undergoing magnetic resonance (MR) examinations [Levine et al, ; Buendia et al, ; Brignole et al, ; Ainslie et al, ]. Access to this powerful diagnostic tool involves significant clinical benefits, although safety considerations have to be made to prevent potential adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance examination of patients with implanted pacemakers: An evaluation of magnetic field gradients slew rate

Trevisan

Miori

Correale

et al. 2017

Bioelectromagnetics

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Performing safe magnetic resonance imaging of patients with "MR conditional" pacemakers needs to meet some specific restrictions. One of these is related to the slew rate (SR) parameter, defined as the speed of magnetic field gradients rising up to their required strengths. Unfortunately, SR values cannot be easily checked at the tomograph console. The present work provides an accurate evaluation of the maximum SR for a set of widely used clinical MR sequences. The experimental approach is based on indirect measurement of time-varying spatial magnetic field gradients. All MR sequences evaluated match safety SR prescriptions. Moreover, an appropriate choice of sequence scan parameters defines some optimized scan protocols tailored for the tomograph considered in the present study. Bioelectromagnetics. 38:307-314, 2017. © 2017 Wiley Periodicals, Inc.

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“…0V0, 0D0, 000, or subthreshold programming were proposed as an alternative. We and others [33] believe that induction of tachyarrhythmias during asynchronous pacing is extremely rare and our strategy followed current general recommendations [10]. Concerns about the potential for induction of ventricular fibrillation during asynchronous pacing in patients with a spontaneous rhythm, have made the use of continuous ECG telemetry and the availability of resuscitation personnel and equipment imperative [34].…”

Section: Discussionmentioning

confidence: 99%

Immediate and 12 months follow up of function and lead integrity after cranial MRI in 356 patients with conventional cardiac pacemakers

Muehling

Wakili²,

Martin³

et al. 2014

Journal of Cardiovascular Magnetic Resonance

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BackgroundConventional cardiac pacemakers are still often regarded as a contraindication to magnetic resonance imaging (MRI). We conducted this study to support the hypothesis that it is safe to scan patients with cardiac pacemakers in a 1.5 Tesla MRI, if close supervision and monitoring as well as adequate pre- and postscan programming is provided.MethodsWe followed up 356 patients (age 61.3 ± 9.1 yrs., 229 men) with single (n = 132) or dual chamber (n = 224) cardiac pacemakers and urgent indication for a cranial MRI for 12 months. The scans were performed at 1.5T. During the scan patients were monitored with a 3-lead ECG and pulse oximetry. Prior to the scan pacemakers were programmed according to our own protocol.ResultsAll 356 scans were completed without complications. No arrhythmias were induced, programmed parameters remained unchanged. No pacemaker dysfunction was identified. Follow-up examinations were performed immediately, 2 weeks, 2, 6, and 12 months after the scan. There was no significant change of pacing capture threshold (ventricular 0.9 ± 0.4 V@0.4 ms, atrial 0.9 ± 0.3 V@0.4 ms) immediately (ventricular 1.0 ± 0.3 V@0.4 ms, atrial 0.9 ± 0.4 V@0.4 ms) or at 12 months follow-up examinations (ventricular 0.9 ± 0.2 V@0.4 ms, atrial 0.9 ± 0.3 V@0.4 ms). There was no significant change in sensing threshold (8.0 ± 4.0 mV vs. 8.1 ± 4.2 mV ventricular lead, 2.0 ± 0.9 mV vs. 2.1 ± 1.0 mV atrial lead) or lead impedance (ventricular 584 ± 179 Ω vs. 578 ± 188 Ω, atrial 534 ± 176 Ω vs. 532 ± 169 Ω) after 12 months.ConclusionsThis supports the evidence that patients with conventional pacemakers can safely undergo cranial MRI in a 1.5T system with suitable preparation, supervision and precautions. Long term follow-up did not reveal significant changes in pacing capture nor sensing threshold.

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Cardiac magnetic resonance imaging at 1.5 T in patients with cardiac rhythm devices

Abstract: Our results suggest that cardiac MRI may be performed safely in appropriately selected patients with close monitoring during the scan without limitation of peak SAR level using several precautionary measures. Image artefacts were more frequent in ICD patients.

Cited by 38 publications

References 35 publications

Safe performance of magnetic resonance of the heart in patients with magnetic resonance conditional pacemaker systems: the safety issue of the ESTIMATE study

Safe performance of magnetic resonance of the heart in patients with magnetic resonance conditional pacemaker systems: the safety issue of the ESTIMATE study

Magnetic resonance examination of patients with implanted pacemakers: An evaluation of magnetic field gradients slew rate

Immediate and 12 months follow up of function and lead integrity after cranial MRI in 356 patients with conventional cardiac pacemakers

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