title: Magnetic resonance imaging-conditional devices: Luxury or real clinical need?
abstract: Although the risk of MRI scanning on patients with conventional devices is lower than initially thought, the patient's safety can only be guaranteed when using MRI-conditional devices. The most important modifications in MRI-conditional devices include a) Reduction in ferromagnetic components to reduce magnetic attraction and susceptibility artifacts; b) Replacement of the reed switch by a Hall sensor in order to avoid unpredictable reed switch behavior; c) Lead coil design to minimize lead heating and electrical current induction; d) Filter circuitry to prevent damage to the internal power supply; and e) Dedicated pacemaker programming to prevent inappropriate pacemaker inhibition and competing rhythms. Although many companies claim to have MRI-conditional devices, adoption in clinical practice is limited because a) Not all companies have MRI-conditional devices approved for both 1.5 and 3T; b) Not all companies offer the option of unlimited MRI scanning (without an exclusion zone in the thorax); c) Certain companies allow only a 30-min MRI scanning and only in afebrile patients; and d) Despite having MRI-conditional pacemakers, certain companies do not have MRI-conditional defibrillators and CRT systems. It is clear that this new technology opens the door for MRI to a growing number of patients; however, the widespread adoption of MRI-conditional devices will depend on real-life issues, such as cost, clinical indications for such a device and the permanent education of health care professionals.
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece. Electronic address: soma13@otenet.gr.
authors.forename: Sophie I
authors.initials: SI
authors.lastname: Mavrogeni
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Poulos
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: Genovefa
authors.initials: G
authors.lastname: Kolovou
authors.affiliation: Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Theodorakis
mesh_terms: D004867:Equipment Design / Q000592:standards*; D004868:Equipment Failure / Q000706:statistics & numerical data; D004869:Equipment Safety / Q000592:standards; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects* / Q000191:economics / Q000592:standards; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000706:statistics & numerical data; D012306:Risk
keywords: Atrioventricular block; Bradyarrythmia; Cardiac magnetic resonance imaging-conditional devices; Ventricular fibrillation; Ventricular tachycardia