Clinical safety and performance of a MRI conditional pacing system in patients undergoing cardiac MRI

Ching, Chi Keong; Chakraborty, Rajarshi; Kler, T.S.; Pumprueg, Satchana; Ngarmukos, Tachapong; Chan, Joseph Yat Sun; Anand, Sumit; Yadav, Rakesh Kumar; Sitthisook, Surapun; Yim, Ka Wing; Jaswal, Rakesh K.; Bhargava, Kartikeya

doi:10.1111/pace.13232

Cited by 9 publications

(3 citation statements)

References 11 publications

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“…Regarding the position, CMR is particularly susceptible to CIED artifacts because it is positioned near the heart, and the closer the generator is to the apex of the left ventricle, the greater the artifacts. Additionally, the stronger the magnetic field, the greater the artifacts [50,51].…”

Section: Issue: Artifactmentioning

confidence: 99%

Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?

Fogante,

Volpato,

Esposto Pirani

et al. 2024

Medicina

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The application of cardiac magnetic resonance (CMR) imaging in clinical practice has grown due to technological advancements and expanded clinical indications, highlighting its superior capabilities when compared to echocardiography for the assessment of myocardial tissue. Similarly, the utilization of implantable cardiac electronic devices (CIEDs) has significantly increased in cardiac arrhythmia management, and the requirements of CMR examinations in patients with CIEDs has become more common. However, this type of exam often presents challenges due to safety concerns and image artifacts. Until a few years ago, the presence of CIED was considered an absolute contraindication to CMR. To address these challenges, various technical improvements in CIED technology, like the reduction of the ferromagnetic components, and in CMR examinations, such as the introduction of new sequences, have been developed. Moreover, a rigorous protocol involving multidisciplinary collaboration is recommended for safe CMR examinations in patients with CIEDs, emphasizing risk assessment, careful monitoring during CMR, and post-scan device evaluation. Alternative methods to CMR, such as computed tomography coronary angiography with tissue characterization techniques like dual-energy and photon-counting, offer alternative potential solutions, although their diagnostic accuracy and availability do limit their use. Despite technological advancements, close collaboration and specialized staff training remain crucial for obtaining safe diagnostic CMR images in patients with CIEDs, thus justifying the presence of specialized centers that are equipped to handle these type of exams.

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Section: Issue: Artifactmentioning

confidence: 99%

Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?

Fogante,

Volpato,

Esposto Pirani

et al. 2024

Medicina

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“…In prospective studies of MRI performance in patients with conditional devices scanned at 1.5 T, no changes in pacing or sensing thresholds were observed. [20][21][22][23] There is currently no published, externally validated data for the scanning of MRIconditional pacemakers or defibrillators at 3 T. However, several CIEDs have been certified as conditional at 3 T according to manufacturer testing.…”

Section: Mri For Conditional Devicesmentioning

confidence: 99%

2021 Update on Safety of Magnetic Resonance Imaging: Joint Statement From Canadian Cardiovascular Society/Canadian Society for Cardiovascular Magnetic Resonance/Canadian Heart Rhythm Society

Panel

Paterson

White

et al. 2021

Canadian Journal of Cardiology

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Magnetic resonance imaging (MRI) is often considered the goldstandard test for characterizing cardiac as well as noncardiac structure and function. However, many patients with cardiac implantable electronic devices (CIEDs) and/or severe renal dysfunction are unable to undergo this test because of safety concerns. In the past 10 years, newer-generation CIEDs and gadolinium-based contrast agents (GBCAs) as well as coordinated care between imaging and heart rhythm device teams have mitigated risk to patients and improved

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“…16 In a 2017 prospective multicenter randomized controlled trial, which included 283 patients with MR conditional dualchamber PMs, a clinical evaluation and device interrogation for each patient 1 month before and after MRI showed no complication. 17 As for ICDs, a 2015 prospective randomized controlled trial, where 263 patients with MR conditional ICDs underwent full-body MRI, reported only mild MRI-related events in patients. 18 Of these, there were 2 implant site warmth sensations, 1 back pain, 1 forehead burning sensation, and 1 atrial tachycardia associated with asynchronous pacing that was converted by the ICD's antitachycardia pacing.…”

Section: Evidence With Mr Conditional Devicesmentioning

confidence: 99%

2020 MR Safety for Cardiac Devices: An Update for Radiologists

et al. 2020

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Magnetic resonance imaging (MRI) is a unique and powerful diagnostic tool that provides images without ionizing radiation and, at times, can be the only modality to properly assess and diagnose some pathologies. Although many patients will need an MRI in their lifetime, many of them are still being unjustly denied access to it due to what were once considered absolute contraindications, including MR nonconditional pacemakers and implantable cardioverter-defibrillators. However, there are a number of large studies that have recently demonstrated that MRI can safely be performed in these patients under certain conditions. In addition, there are an increasing number of novel cardiac devices implanted in patients who may require an MRI. Radiologists need to familiarize themselves with these devices, identify which patients with these devices can safely undergo MRI, and under which conditions. In this article, we will review the current literature on MR safety and cardiac devices, elaborate on how to safely image patients with cardiac devices, and share the expertise of our tertiary cardiac institute.

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Clinical safety and performance of a MRI conditional pacing system in patients undergoing cardiac MRI

Abstract: cMRI scanning with 1.5 T scanners is safe in patients implanted with the Accent MRI™ conditional pacing system and has no significant effect on the electrical parameters of the device and leads.

Cited by 9 publications

References 11 publications

Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?

Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?

2021 Update on Safety of Magnetic Resonance Imaging: Joint Statement From Canadian Cardiovascular Society/Canadian Society for Cardiovascular Magnetic Resonance/Canadian Heart Rhythm Society

2020 MR Safety for Cardiac Devices: An Update for Radiologists

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