Current Clinical Issues for MRI Scanning of Pacemaker and Defibrillator Patients

Abstract

Dramatic increases in both magnetic resonance imaging (MRI) usage and cardiac device-based therapy have resulted in an estimated 50-75% probability of a patient being indicated for an MRI over the lifetime of their device. Some recent studies have demonstrated "safe procedures" and "no adverse events" in the limited populations, clinical situations, and specific devices and lead orientations tested. While these investigations are useful to help ascertain the hazards for patients with cardiac devices, they do not demonstrate clear freedom from risk. All components of active implantable systems must be engineered during the design stage to provide safety in current and evolving MR environments. Device manufacturers need to secure regulatory approval to confirm their products' safety under multiple clinical and technical variables.

Role of cardiac MRI and CT in Fontan circulation

“…Historically concerns have been raised regarding potential life-threatening interactions between PPM/ICD and MRI [54,55]. This has led to the development of more MRI conditional devices [56].…”

Utilization and likelihood of radiologic diagnostic imaging in patients with implantable cardiac defibrillators

“…Kalin and Stanton4 reported that the combination of greater MRI use and more patients with ICDs coupled with expanded Medicare coverage leads to a projected range from 50% to 75% of ICD patients needing an MRI over the lifetime of the device.…”

MRI conditional pacemakers: the start of a new era

“…Although pacing boxes can be changed, the pacing leads are essentially permanent. This is problematic for these patients, given the recent data that states there is a 50-75% chance of a patient with a pacemaker or implanted cardiac defibrillator needing an MR scan at some point in their life [5]. As a result, pacing technology manufacturers have focused their research for some time on developing an MR compatible pacing system.…”