Magnetic Resonance Imaging in Nondependent Pacemaker Patients with Pacemakers and Defibrillators with a Nearly Depleted Battery.
BACKGROUND
Magnetic resonance imaging (MRI) in patients with non-MRI-conditional cardiac implantable electronic devices (CIEDs) has been shown to be safe when performed under closely monitored protocols. However, the safety of MRI in patients with devices with a nearly depleted battery has not been reported.


METHODS
Prospective data were collected between January 2008 and May 2015 in patients with non-MRI-conditional CIEDs undergoing clinically indicated MRI under institutional protocol. Patients who were pacemaker dependent were excluded. Patients whose devices were at elective replacement indicator (ERI) at the time of MRI or close to ERI (ERI or replacement for battery depletion within 3 months of scan) were identified through database review and analyzed for clinical events.


RESULTS
MRI scans (n = 569) were performed in 442 patients. Of these, we identified 13 scans performed with a nearly depleted battery in nine patients. All scans with implantable cardioverter defibrillators (ICDs, n = 9) were uneventful. However, two scans with pacemakers close to ERI resulted in a power-on-reset (PoR) event. One scan with a pacemaker close to ERI that was programmed to DOO mode reached ERI during MRI and automatically changed to VVI mode. Additionally, one scan with a pacemaker at ERI did not allow programming. All pacemakers with events were implanted before 2005.


CONCLUSIONS
Patients with pacemakers and ICDs with a nearly depleted battery can safely undergo MRI when patients are not pacemaker dependent. Attention should be paid because old devices can result in PoR or ERI during MRI, which may lead to oversensing and inhibition of pacing.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Hideo
H
Okamura
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Deepak
D
Padmanabhan
Division of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota.
Robert E
RE
Watson
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Connie
C
Dalzell
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Nancy
N
Acker
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Mary
M
Jondal
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Abby L
AL
Romme
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Yong-Mei
YM
Cha
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Samuel J
SJ
Asirvatham
Division of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota.
Joel P
JP
Felmlee
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Paul A
PA
Friedman
D000368:Aged; D015984:Causality; D000075202:Contraindications; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D011211:Electric Power Supplies; D004867:Equipment Design; D004868:Equipment Failure / Q000706:statistics & numerical data*; D019544:Equipment Failure Analysis; D004869:Equipment Safety / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000706:statistics & numerical data*; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors
ERI; ICD; MRI; depleted battery; pacemaker