Cardiac pacemakers and implantable cardioverter defibrillators are unaffected by operation of an extremity MR imaging system.

Shellock, Frank G.; O'Neil, Michael J.; Ivans, Veronica; Kelly, Dee; O’Connor, Mary; Toay, L; Crues, John V.

doi:10.2214/ajr.172.1.9888762

Cited by 65 publications

(30 citation statements)

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“…Cardiac pacemakers are the most common electrically active implants found in patients who may be referred for MR procedures. 2,12 Thus, it is critical that there is an understanding of the risks of these devices in the MR environment, with the goal of designing devices that are MR compatible.…”

Section: Importance Of Obtaining Mr Scans In Patients With Implanted mentioning

confidence: 99%

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

et al. 2004

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Background-MRI has unparalleled soft-tissue imaging capabilities. The presence of devices such as pacemakers and implantable cardioverter/defibrillators (ICDs), however, is historically considered a contraindication to MRI. These devices are now smaller, with less magnetic material and improved electromagnetic interference protection. Our aim was to determine whether these modern systems can be used in an MR environment. Methods and Results-We tested in vitro and in vivo lead heating, device function, force acting on the device, and image distortion at 1.5 T. Clinical MR protocols and in vivo measurements yielded temperature changes Ͻ0.5°C. Older (manufactured before 2000) ICDs were damaged by the MR scans. Newer ICD systems and most pacemakers, however, were not. The maximal force acting on newer devices was Ͻ100 g. Modern (manufactured after 2000) ICD systems were implanted in dogs (nϭ18), and after 4 weeks, 3-to 4-hour MR scans were performed (nϭ15). No device dysfunction occurred. The images were of high quality with distortion dependent on the scan sequence and plane. Pacing threshold and intracardiac electrogram amplitude were unchanged over the 8 weeks, except in 1 animal that, after MRI, had a transient (Ͻ12 hours) capture failure. Pathological data of the scanned animals revealed very limited necrosis or fibrosis at the tip of the lead area, which was not different from controls (nϭ3) not subjected to MRI. Conclusions-These

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Section: Importance Of Obtaining Mr Scans In Patients With Implanted mentioning

confidence: 99%

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

et al. 2004

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“…Cardiac pacemakers present potential problems to patients undergoing MR procedures from several mechanisms, including: 1) movement of the pacemaker (implantable pulse generator and/or leads) due to the strong static magnetic field of the MR system; 2) MRIrelated heating of the pacemaker lead by the time-varying fields; 3) inhibition or modification of the function of the pacemaker by the electromagnetic fields used for MRI; and 4) inappropriate or rapid pacing due to pulsed gradient magnetic fields and/or pulsed radio frequency (RF) fields (i.e., electromagnetic interference) from the operating MR system (i.e., with the pacing lead acting as an antenna) (4,5,8,(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60). These problems may result in serious injuries or lethal consequences for patients.…”

Section: Mr Safe Fiber-optic Cardiac Pacing Leadmentioning

confidence: 99%

Magnetic resonance safety update 2002: Implants and devices

Shellock

2002

Magnetic Resonance Imaging

250

279

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The preservation of a safe magnetic resonance (MR) environment requires constant vigilance by MR healthcare professionals, particularly with regard to the management of patients with metallic biomedical implants or devices. The variety and complexity of implants and devices constantly changes, requiring continuous attention and diligence with regard to obtaining the most current and accurate information about these objects relative to the MR environment. This review article discusses MR safety and MR compatibility issues and presents important information for a variety of implants and devices, with an emphasis on those objects that have recently undergone evaluation or that require additional consideration because of existing controversy or confusion.

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“…There are potential effects of MRI to cardiac pacemakers and ICDs that were considered to be absolutely contraindicated due to the following potential issues (Shellock et al 1999): (1) Movement and/or vibration of the pulse generator or lead(s); (2) Temporary or permanent modification of the function (i.e. damage) of the device; (3) Inappropriate sensing, triggering, or activation of the device; (4) Excessive heating of the leads; (5) Induced currents in the leads and (6) Electromagnetic interference.…”

Section: Decision Making Processes For a Patient With Cardiac Pacemakmentioning

confidence: 99%

“…According to clinical guidelines, there are altered physiologies to be considered when patients are brought into the radiology departments that have pacemakers or ICDs. Primarily it may lead to radiation frequency (RF) interference, shifting location of pacemakers, and thermal effect (Shellock et al 1999).…”

Section: The Casementioning

confidence: 99%

Decision Making Processes for a Patient with Cardiac Pacemaker Admitted to the Accident and Emergency Undergoing Magnetic Resonance Imaging – A Case Study

Raditya¹

2017

AJSTD

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The three basic models of decision-making -the descriptive, prescriptive and normativewere applied. The prescriptive used the information processing theory, while the normative used decision trees as decision options and lastly, the descriptive used intuition and pattern recognition.Dominantly, the prescriptive model for decision-making is more appropriate for this case. The descriptive decision-making model, using intuition however, helped in supporting the intuitive hypothesis. Lastly, the normative model of decision-making played an important role but was not likely effective.

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Cardiac pacemakers and implantable cardioverter defibrillators are unaffected by operation of an extremity MR imaging system.

Abstract: Pacemakers and implantable cardioverter defibrillatorswere provided by Medtronic, Inc., Minneapolis, MN.

Cited by 65 publications

References 0 publications

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

Modern Pacemaker and Implantable Cardioverter/Defibrillator Systems Can Be Magnetic Resonance Imaging Safe

Magnetic resonance safety update 2002: Implants and devices

Decision Making Processes for a Patient with Cardiac Pacemaker Admitted to the Accident and Emergency Undergoing Magnetic Resonance Imaging – A Case Study

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