title: Multicenter study of the safety and effects of magnetic resonance imaging in patients with coronary sinus left ventricular pacing leads.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) in patients with left ventricular (LV) leads may cause tissue or lead heating, dislodgment, venous damage, or lead dysfunction.
  
  
  OBJECTIVE
  The purpose of this study was to determine the safety of MRI in patients with LV pacing leads.
  
  
  METHODS
  Prospective data on patients with coronary sinus LV leads undergoing clinically indicated MRI at 3 institutions were collected. Patients were not pacemaker-dependent. Scans were performed under pacing nurse, technician, radiologist, and physicist supervision using continuous vital sign, pulse oximetry, and ECG monitoring and a 1.5-T scanner with specific absorption rate <1.5 W/kg. Devices were interrogated pre- and post-MRI, programmed to asynchronous or inhibition mode with tachyarrhythmia therapies off (if present), and reprogrammed to their original settings post-MRI.
  
  
  RESULTS
  MRI scans (n = 42) were performed in 40 patients with non-MRI conditional LV leads between 2005 and 2013 (mean age 67 ± 9 years, n = 16 [40%] women, median lead implant duration 740 days with interquartile range 125-1173 days). MRIs were performed on the head/neck/spine (n = 35 [83%]), lower extremities (n = 4 [10%]), chest (n = 2 [5%]), and abdomen (n = 1 [2%]). There were no overall differences in pre- and post-MRI interrogation LV lead sensing (12.4 ± 6.2 mV vs 12.9 ± 6.7 mV, P = .38), impedance (724 ± 294 Ω vs 718 ± 312 Ω, P = .67), or threshold (1.4 ± 1.1 V vs 1.4 ± 1.0 V, P = .91). No individual LV lead changes required intervention.
  
  
  CONCLUSIONS
  MRI scanning was performed safely in non-pacemaker-dependent patients with coronary sinus LV leads who were carefully monitored during imaging without clinically significant adverse effect on LV lead function.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Seth H
authors.initials: SH
authors.lastname: Sheldon
authors.affiliation: Intermountain Heart Institute, Intermountain Medical Center, Murray, Utah.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.affiliation: Oklahoma Heart Institute, Tulsa, Oklahoma.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Cogert
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Nancy G
authors.initials: NG
authors.lastname: Acker
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Connie M
authors.initials: CM
authors.lastname: Dalzell
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: John V
authors.initials: JV
authors.lastname: Higgins
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Raul E
authors.initials: RE
authors.lastname: Espinosa
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Joel P
authors.initials: JP
authors.lastname: Felmlee
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Watson
authors.affiliation: Intermountain Heart Institute, Intermountain Medical Center, Murray, Utah.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
authors.affiliation: Oklahoma Heart Institute, Tulsa, Oklahoma.
authors.forename: Miriam H
authors.initials: MH
authors.lastname: Brooks
authors.affiliation: Intermountain Heart Institute, Intermountain Medical Center, Murray, Utah.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Osborn
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: friedman.paul@mayo.edu.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D054326:Coronary Sinus / Q000601:surgery*; D004562:Electrocardiography; D004567:Electrodes, Implanted; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D010138:Pacemaker, Artificial; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cardiac implantable electronic device; Cardiac resynchronization device; Coronary sinus; Implantable cardioverter-defibrillator; Magnetic resonance imaging; Safety