title: Safety, feasibility, and diagnostic value of cardiac magnetic resonance imaging in patients with cardiac pacemakers and implantable cardioverters/defibrillators at 1.5 T.
abstract: BACKGROUND
  Recent studies suggest that magnetic resonance (MR) imaging of the brain and spine may safely be performed in patients with pacemakers (PMs) and implantable cardioverter/defibrillators (ICDs), when taking adequate precautions. The aim of this study was to investigate safety, feasibility, and diagnostic value (DV) of MR imaging in cardiac applications (cardiac MR [CMR]) in patients with PMs and ICDs for the first time.
  
  
  METHODS
  Thirty-two PM/ICD patients with a clinical need for CMR were examined. The specific absorption rate was limited to 1.5 W/kg. Devices were reprogrammed pre-CMR to minimize interference with the electromagnetic fields. Devices were interrogated pre-CMR and post-CMR and after 3 months. Troponin I levels were measured pre-CMR and post-CMR; image quality (IQ) and DV of CMR were assessed.
  
  
  RESULTS
  All devices could be reprogrammed normally post-CMR. No significant changes of pacing capture threshold, lead impedance, and troponin I were observed. Image quality in patients with right-sided devices (RSD) was better compared with that in patients with left-sided devices (LSD) (P < .05), and less myocardial segments were affected by device-related artefacts (P < .05). Diagnostic value was rated as sufficiently high, allowing for diagnosis, or better in 12 (100%) of 12 patients with RSD, and only in 7 (35%) of 20 patients with LSD.
  
  
  CONCLUSIONS
  Cardiac MR may be performed safely when limiting specific absorption rate, appropriately monitoring patients, and following device reprogramming. Cardiac MR delivers good IQ and DV in patients with RSD. Cardiac MR in patients with RSD may therefore be performed with an acceptable risk/benefit ratio, whereas the risk/benefit ratio is rather unfavorable in patients with LSD.
authors.affiliation: Department of Radiology, University of Bonn, Bonn, Germany.
authors.forename: Claas P
authors.initials: CP
authors.lastname: Naehle
authors.forename: Jens
authors.initials: J
authors.lastname: Kreuz
authors.forename: Katharina
authors.initials: K
authors.lastname: Strach
authors.forename: Jörg Otto
authors.initials: JO
authors.lastname: Schwab
authors.forename: Simon
authors.initials: S
authors.lastname: Pingel
authors.forename: Roger
authors.initials: R
authors.lastname: Luechinger
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Hans
authors.initials: H
authors.lastname: Schild
authors.forename: Daniel
authors.initials: D
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D002304:Cardiac Pacing, Artificial; D000075202:Contraindications; D017147:Defibrillators, Implantable; D054459:Elasticity Imaging Techniques; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D010138:Pacemaker, Artificial; D019210:Troponin I / Q000097:blood*; D055815:Young Adult
chemical_list: D019210:Troponin I