title: The Safety of Cardiac and Thoracic Magnetic Resonance Imaging in Patients with Cardiac Implantable Electronic Devices.
abstract: Studies reporting the safety of magnetic resonance imaging (MRI) in patients with a cardiac implantable electronic device (CIED) have mostly excluded examinations with the device in the magnet isocenter. The purpose of this study was to describe the safety of cardiac and thoracic spine MRI in patients with a CIED.
  
  
  
  The medical records of patients with a CIED who underwent a cardiac or thoracic spine MRI between January 2011 and December 2014 were reviewed. Devices were interrogated before and after imaging with reprogramming to asynchronous pacing in pacemaker-dependent patients. The clinical interpretability of the MRI and peak and average specific absorption rates (SARs, W/kg) achieved were determined.
  
  
  
  Fifty-eight patients underwent 51 cardiac and 11 thoracic spine MRI exams. Twenty-nine patients had a pacemaker and 29 had an implantable cardioverter defibrillator. Seventeen percent (n = 10) were pacemaker dependent. Fifty-one patients (89%) had non-MRI-conditional devices. There were no clinically significant changes in atrial and ventricular sensing, impedance, and threshold measurements. There were no episodes of device mode changes, arrhythmias, therapies delivered, electrical reset, or battery depletion. One study was prematurely discontinued due to a patient complaint of chest pain of which the etiology was not determined. Across all examinations, the average peak SAR was 2.0 ± 0.85 W/kg with an average SAR of 0.35 ± 0.37 W/kg. Artifact significantly limiting the clinical interpretation of the study was present in 33% of cardiac MRI studies.
  
  
  
  When a comprehensive CIED magnetic resonance safety protocol is followed, the risk of performing 1.5-T magnetic resonance studies with the device in the magnet isocenter, including in patients who are pacemaker dependent, is low.
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dandamudi
authors.affiliation: Department of Radiology, Northwestern University, Chicago, Illinois.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Collins
authors.affiliation: Department of Radiology, Northwestern University, Chicago, Illinois.
authors.forename: James C
authors.initials: JC
authors.lastname: Carr
authors.affiliation: Department of Radiology, Northwestern University, Chicago, Illinois.
authors.forename: Pat
authors.initials: P
authors.lastname: Mongkolwat
authors.affiliation: Department of Radiology, Northwestern University, Chicago, Illinois.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Rahsepar
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Todd T
authors.initials: TT
authors.lastname: Tomson
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Nishant
authors.initials: N
authors.lastname: Verma
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Rishi
authors.initials: R
authors.lastname: Arora
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Alex B
authors.initials: AB
authors.lastname: Chicos
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Lin
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611.
authors.forename: Rod S
authors.initials: RS
authors.lastname: Passman
authors.affiliation: Department of Medicine, Division of Cardiology, Northwestern University, 251 E Huron St, Feinberg 8-503E, Chicago, IL 60611. Electronic address: bknight@nmff.org.
authors.forename: Bradley P
authors.initials: BP
authors.lastname: Knight
mesh_terms: D016477:Artifacts; D002574:Cervical Vertebrae; D000075204:Contraindications, Procedure; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004869:Equipment Safety; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis; D006352:Heart Ventricles; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D061214:Patient Safety; D013122:Spinal Diseases / Q000175:diagnosis; D013904:Thoracic Vertebrae
keywords: Cardiac implantable electronic device; adverse effects; artifact; isocenter; magnetic resonance imaging; safety; specific absorption rate