title: MRI with cardiac pacing devices - safety in clinical practice.
abstract: OBJECTIVE
  The aim of this study was to introduce a single centre "real life" experience of performing MRI examinations in clinical practice on patients with cardiac pacemaker systems. Additionally, we aimed to evaluate the safety of using a dedicated safety protocol for these patients.
  
  
  METHODS
  We used a 1.5T MRI scanner to conduct 68 MRI scans of different body regions in patients with pacing systems. Of the cardiac devices, 32% were MR-conditional, whereas the remaining 68% were MR-unsafe. We recorded the functional parameters of the devices prior, immediately after, and approximately one month after the MRI scanning, and compared the device parameters to the baseline values.
  
  
  RESULTS
  All MRI examinations were completed safely, and each device could be interrogated normally following the MRI. We observed no changes in the programmed parameters of the devices. For most of the participants, the distributions of the immediate and one-month changes in the device parameters were within 20% of the baseline values, although some changes approached clinically important thresholds. Furthermore, we observed no differences in the variable changes between MR-conditional and MR-unsafe pacing systems, or between scans of the thorax area and other scanned areas.
  
  
  CONCLUSIONS
  MRI in patients with MR-conditional pacing systems and selected MR-unsafe systems could be performed safely under strict conditions in this study.
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland; Department of Physics, University of Helsinki, Finland. Electronic address: touko.kaasalainen@hus.fi.
authors.forename: Touko
authors.initials: T
authors.lastname: Kaasalainen
authors.affiliation: HUS Department of Cardiology, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland. Electronic address: sami.pakarinen@hus.fi.
authors.forename: Sami
authors.initials: S
authors.lastname: Pakarinen
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland. Electronic address: sari.kivisto@hus.fi.
authors.forename: Sari
authors.initials: S
authors.lastname: Kivistö
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland. Electronic address: miia.holmstrom@hus.fi.
authors.forename: Miia
authors.initials: M
authors.lastname: Holmström
authors.affiliation: HUS Department of Cardiology, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland. Electronic address: helena.hanninen@hus.fi.
authors.forename: Helena
authors.initials: H
authors.lastname: Hänninen
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland; Department of Biomedical Engineering and Computational Science, School of Science, Aalto University, Helsinki, Finland. Electronic address: juha.peltonen@hus.fi.
authors.forename: Juha
authors.initials: J
authors.lastname: Peltonen
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland. Electronic address: kirsi.lauerma@hus.fi.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Lauerma
authors.affiliation: HUS Medical Imaging Center, Helsinki University Central Hospital, POB 340 (Haartmaninkatu 4), 00290 Helsinki, Finland. Electronic address: outi.sipila@hus.fi.
authors.forename: Outi
authors.initials: O
authors.lastname: Sipilä
mesh_terms: D000368:Aged; D000465:Algorithms; D004562:Electrocardiography; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010092:Oximetry; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D061214:Patient Safety; D012189:Retrospective Studies; D017751:Safety Management
keywords: Cardiac pacemaker; Magnetic resonance imaging; Safety protocol