[Safety of cardiac pacemakers and implantable cardioverter-defibrillators in magnetic resonance imaging. Assessment of the aggregate function at 1.5 tesla].
OBJECTIVE
Magnetic resonance imaging (MRI) is increasingly used in patients, but it is contraindicated in those with cardiac pacemakers (CP) or implantable cardioverter defibrillators (ICD). This study examined circumstances in which potentially life-threatening arrhythmias may be triggered in patients with CP undergoing MRI and whether these problems can be avoided by reprogramming of these devices.


METHODS
Eight CP and seven ICDs were investigated in a phantom at 1.5 tesla (experimental and imaging sequences).


RESULTS
A decrease in battery voltage was found in four CP after MRI (indication for elective replacement). Additionally, three showed changes in programming (resets). Analogous changes did not appear in the tested ICDs, but periods of tachycardia were recorded in all types of devices during MRI depending on the pulse sequence employed.


CONCLUSIONS
MRI-related electromagnetic fields as used in routine MRI can induce severe pacemaker device malfunctions. Device programming approaches are unreliable for prevention of patient hazards, as programming changes or resets are one of the primary malfunctions during MRI.
Nordbeck
P
P
Medizinische Klinik und Poliklinik I, Universität Würzburg. nordbeck@physik.uni-wuerzburg.de
Bauer
W R
WR
D001145:Arrhythmias, Cardiac / Q000209:etiology*; D000075202:Contraindications; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000592:standards; D004868:Equipment Failure; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000592:standards; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000592:standards; D019047:Phantoms, Imaging; D012449:Safety