title: Magnetic resonance imaging in patients with cardiac implanted electronic devices: focus on contraindications to magnetic resonance imaging protocols.
abstract: OBJECTIVE
  Magnetic resonance imaging (MRI) has been reported to be safe in patients with cardiac implantable electronic devices (CIED) provided a specific protocol is followed. The objective of this study was to assess whether this is also true for patients excluded from published protocols.
  
  
  RESULTS
  A total of 160 MRIs were obtained in 142 consecutive patients with CIEDs [106 patients had an implantable cardioverter defibrillator (ICD) and 36 had a pacemaker implanted] using an adapted, pre-specified protocol. A cardiac MRI was performed in 95 patients, and a spinal/brain MRI was performed in 47 patients. Forty-six patients (32%) had either abandoned leads (n = 10), and/or were pacemaker dependent with an implanted ICD (n = 19), had recently implanted CIEDs (n = 1), and/or had a CIED device with battery depletion (n = 2), and/or a component of the CIED was recalled or on advisory (n = 32). No major complications occurred. Some device parameters changed slightly, but significantly, right after or at 1-week post-MRI without requiring any reprogramming. In one patient with an ICD on advisory, the pacing rate changed inexplicably during one of his two MRIs from 90 to 50 b.p.m.
  
  
  CONCLUSIONS
  Using a pre-specified protocol, cardiac and non-cardiac MRIs were performed in CIED patients with pacemaker dependency, abandoned leads, or depleted batteries without occurrence of major adverse events. Patients with devices on advisory need to be monitored carefully during MRI, especially if they are pacemaker dependent.
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC 5853, Ann Arbor, MI 48109-5853, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Horwood
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Anil
authors.initials: A
authors.lastname: Attili
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Luba
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: El-Sayed H
authors.initials: EH
authors.lastname: Ibrahim
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Hemant
authors.initials: H
authors.lastname: Parmar
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Jadranka
authors.initials: J
authors.lastname: Stojanovska
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC 5853, Ann Arbor, MI 48109-5853, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Gadoth-Goodman
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC 5853, Ann Arbor, MI 48109-5853, USA.
authors.forename: Carey
authors.initials: C
authors.lastname: Fette
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC 5853, Ann Arbor, MI 48109-5853, USA.
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, 1500 E. Medical Center Dr., SPC 5853, Ann Arbor, MI 48109-5853, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
mesh_terms: D002058:Burns, Electric / Q000209:etiology* / Q000517:prevention & control; D000075202:Contraindications; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Abandoned leads; Cardiac implanted electronic devices; Contraindication; Devices on advisory; Magnetic resonance imaging; Pacemaker dependency; Recalled devices