Safety and Quality of 1.5-T MRI in Patients With Conventional and MRI-Conditional Cardiac Implantable Electronic Devices After Implementation of a Standardized Protocol.
OBJECTIVE
The purpose of this study was to evaluate the safety and diagnostic utility of 1.5-T MRI examinations of individuals with conventional and MRI-conditional cardiac implantable electronic devices (CIEDs).


METHODS
Patients with a CIED who were referred for MRI were evaluated by radiologists and cardiac electrophysiologists for study participation. CIED interrogation was performed immediately before and after MRI, and cardiac telemetry monitoring was performed during MRI. CIED programming changes, malfunctions, and intraprocedural events were documented. Whether diagnostic questions were answered and whether artifacts related to the CIED were present and negatively affected image interpretation were recorded.


RESULTS
One hundred thirteen MRI examinations were performed for 104 patients with CIEDs (74 pacemakers [60 conventional, 14 MRI conditional]; 39 implantable cardiac defibrillators). Device reprogramming was required before MRI for 62.8% of studies (71/113). No significant changes in lead parameters were noted during or after MRI. Electromagnetic noise was detected on at least one lead in 7.1% of studies. Three patients reported transient symptoms (one case each of heating at the pocket site, tingling at the pocket site, and palpitations). All images were considered diagnostic for the original clinical query. Artifacts related to CIEDs were described in 3.5% of MRI reports (4/113) and were present only when the pulse generator was included in the FOV. CIED-related artifacts limited evaluation of tissues immediately adjacent to the pulse generator.


CONCLUSIONS
Establishment of a multidisciplinary work flow allows individuals with conventional and MRI-conditional CIEDs to safely undergo 1.5-T MRI with diagnostic questions consistently answered.
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322.
Juan C
JC
Camacho
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322.
Courtney Coursey
CC
Moreno
2 Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Anand D
AD
Shah
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322.
Pardeep K
PK
Mittal
2 Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Andenet
A
Mengistu
2 Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Michael S
MS
Lloyd
2 Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Mikhael F
MF
El-Chami
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322.|2 Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Stamatios
S
Lerakis
1 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322.
Amit M
AM
Saindane
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D061214:Patient Safety
MRI; MRI safety; MRI-conditional pacemaker; defibrillator; pacemaker