SCMR expert consensus statement for cardiovascular magnetic resonance of patients with a cardiac implantable electronic device

Kim, Daniel; Collins, Jeremy D.; White, James A.; Hanneman, Kate; Lee, Daniel C.; Patel, Amit R.; Hu, Peng; Litt, Harold; Weinsaft, Jonathan W.; Davids, Rachel; Mukai, Kanae; Ng, Ming-Yen; Luetkens, Julian A.; Roguin, Ariel; Rochitte, Carlos E.; Woodard, Pamela K.; Manisty, Charlotte; Zareba, Karolina M.; Mont, Lluis; Bogun, Frank; Ennis, Daniel B.; Nazarian, Saman; Webster, Gregory; Stojanovska, Jadranka

doi:10.1016/j.jocmr.2024.100995

Cited by 7 publications

(5 citation statements)

References 154 publications

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“…97 Furthermore, balanced SSFP sequences are the most dangerous in terms of a lead-tip heating phenomenon because they often use large flip angles that can lead to higher RF energy deposits in the patient. 98 The gradient magnetic fields are magnetic fields that are continuously switched on and off during the scan since they are used for spatial encoding. Similarly to what happens with RF fields, this temporary magnetic field can induce an electrical current that stimulates peripheral nerves (so-called peripheral nerve stimulation phenomenon) or interfere with the pacing and sensing functions.…”

Section: Cmr In Lvad Patientsmentioning

confidence: 99%

“…99 To perform the scan, following international guidelines on CMR examination on patients with CIED as well as local protocols is advisable. 98,100 In the event of a life-threatening arrhythmia, it is important to remember that ICD shock in the scanner area could fail due to possible interference of the magnetic static field on the ICD capacitor. 101 Although the above-mentioned pitfalls to be aware of, with due precautions scanning patients with CIED is generally safe and it is becoming gradually more common in clinical practice.…”

Section: Cmr In Lvad Patientsmentioning

confidence: 99%

“…92 There are many strategies to mitigate these effects of CIEDs on CMR, like increasing the distance between the generator and the heart by lifting the left arm, 102 using deep learning techniques to overcome the artifacts, 103 or using smaller voxels, and smaller echo times with shorter RF pulses and larger receiver bandwidth in the frequency encoded direction. 98 A technique that showed the best results in correcting the artifacts is the use of wideband inversion pulses for IR or saturation recovery (SR) sequences. When applying these sequences, the CIEDs cause an off-resonance that undermines the presequence pulse preparation (like IR or SR), making the images very difficult to read.…”

Section: Scanning Patients With Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

“…When applying these sequences, the CIEDs cause an off-resonance that undermines the presequence pulse preparation (like IR or SR), making the images very difficult to read. 98 Using a wider spectral bandwidth was proposed by Rashid et al 104,105 and has been proven to be effective in clinical practice. 105,106 Other devices can be used as therapy in advanced HF, such as cardiac contractility modulators and interatrial shunt devices.…”

Section: Scanning Patients With Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

“…108,109 A cardiac contractility modulator is a transvenous device with a catheter to the right interventricular septum (IVS) that delivers high voltage impulses in the RV during the absolute refractory period, improving the calcium handling of the myocytes; this device is MR conditional only at 1,5 T for the head and the extremities. 98,110 In conclusion, the timing of scans poses challenges when managing CMR and advanced HF patients. There are instances where HF patients may find it difficult to tolerate extended periods of supine positioning or prolonged breath-holding requirements during scanning procedures.…”

Section: Scanning Patients With Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

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Cardiac magnetic resonance in advanced heart failure

Coraducci,

De Zan,

Fedele

et al. 2024

Echocardiography

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Heart failure (HF) is a chronic and progressive disease that often progresses to an advanced stage where conventional therapy is insufficient to relieve patients' symptoms. Despite the availability of advanced therapies such as mechanical circulatory support or heart transplantation, the complexity of defining advanced HF, which requires multiple parameters and multimodality assessment, often leads to delays in referral to dedicated specialists with the result of a worsening prognosis. In this review, we aim to explore the role of cardiac magnetic resonance (CMR) in advanced HF by showing how CMR is useful at every step in managing these patients: from diagnosis to prognostic stratification, hemodynamic evaluation, follow‐up and advanced therapies such as heart transplantation. The technical challenges of scanning advanced HF patients, which often require troubleshooting of intracardiac devices and dedicated scans, will be also discussed.

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Section: Cmr In Lvad Patientsmentioning

confidence: 99%

Section: Cmr In Lvad Patientsmentioning

confidence: 99%

Section: Scanning Patients With Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

Section: Scanning Patients With Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

Section: Scanning Patients With Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

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Cardiac magnetic resonance in advanced heart failure

Coraducci,

De Zan,

Fedele

et al. 2024

Echocardiography

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Aortic velocity measurements derived from phase‐contrast MRI are influenced by a cardiac implantable electronic device in both adult and pediatric human subjects

Yang,

Aboyewa,

Webster

et al. 2024

Magnetic Resonance in Med

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PurposeOverall there is a lack of evidence on the accuracy and precision of phase‐contrast (PC) MRI in patients with cardiac implantable electronic devices (CIEDs). The purpose of this study is to determine whether aortic velocity measurements are influenced by a CIED.MethodsWe scanned 21 adult patients and 8 pediatric volunteers using clinical standard PC and real‐time PC (rt‐PC) sequences with and without a CIED generator taped on human subjects (below the left clavicle for adults and children; also on the abdomen for children) to mimic image artifacts. Peak and mean velocities above the aortic valve were calculated.ResultsThe Bland–Altman analyses on peak velocity measurements in pediatric subjects showed that both the accuracy and precision worsen as the distance between the CIED and aortic valve decreases (i.e., from abdomen to below the left clavicle). Specifically, both the bias and the coefficient of variation (CV) for both clinical PC and rt‐PC increased from the abdominal position (clinical: bias = −1.1%, CV = 4.3%; rt‐PC: bias = −0.3%, CV = 3.4%) to the clavicle position (clinical: bias = −4.0%, CV = 8.1%; rt‐PC: bias = 8.2%, CV = 7.3%). A similar trend was observed for mean velocity. The mean difference in peak and mean velocity measurements between rt‐PC with CIED (either position) and clinical standard PC with no CIED was within 7.5%. In adult patients, the mean difference between rt‐PC with CIED and clinical standard PC with CIED in peak velocity was 6.9%, and the CV was 7.9%.ConclusionThis study demonstrates that aortic velocity measurements are influenced by CIED in both adult and pediatric subjects.

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