1
|
Pieri C, Bhuva A, Moralee R, Abiodun A, Gopalan D, Roditi GH, Moon JC, Manisty C. Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators. Open Heart 2021; 8:e001598. [PMID: 34031214 PMCID: PMC8149430 DOI: 10.1136/openhrt-2021-001598] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine provision of MRI for patients with cardiac implantable electronic devices (CIEDs; pacemakers and defibrillators) in England, to understand regional variation and assess the impact of guideline changes. METHODS Retrospective data related to MRI scans performed in patients with CIED over the preceding 12 months was collected using a structured survey tool distributed to every National Health Service Trust MRI unit in England. Data were compared with similar data from 2014/2015 and with demand (estimated from local CIED implantation rates and regional population data by sustainability and transformation partnerships (STPs)). RESULTS Responses were received from 212 of 223 (95%) hospitals in England. 112 (53%) MRI units' scan patients with MR-conditional CIEDs (10% also scan non-MR conditional devices), compared with 46% of sites in 2014/2015. Total annual scan volume increased over fourfold between 2014 and 2019 (1090 to 4896 scans). There was widespread geographical variation, with five STPs (total population >3·5 million representing approximately 25 000 patients with CIED) with no local provision. There was no correlation between local demand (CIED implantation rates) and MRI provision (scan volume). Complication rates were extremely low with three events nationally in 12 months (0·06% CIED-MRI scans). CONCLUSIONS Provision of MRI for patients with CIEDs in England increased over fourfold in 4 years, but an estimated 10-fold care gap remains. Almost half of hospitals and 1 in 10 STPs have no service, with no relationship between local supply and demand. Availability of MRI for patients with non-MR conditional devices, although demonstrably safe, remains limited.
Collapse
Affiliation(s)
- Christopher Pieri
- Institute of Health Sciences, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
| | - Anish Bhuva
- Department of Cardiology, Barts Health NHS Trust, London, UK
- Department of Radiology, Imperial College London, London, UK
| | - Russell Moralee
- Department of Radiology, Imperial College London, London, UK
| | - Aderonke Abiodun
- Department of Cardiology, Barts Health NHS Trust, London, UK
- Department of Radiology, Imperial College London, London, UK
| | - Deepa Gopalan
- Department of Radiology, University of Glasgow, Glasgow, UK
| | - Giles H Roditi
- Department of Cardiovascular Imaging, Barts Heart Centre, London, Greater London, UK
| | - James C Moon
- Department of Cardiology, Barts Health NHS Trust, London, UK
- Department of Radiology, Imperial College London, London, UK
| | - Charlotte Manisty
- Department of Cardiology, Barts Health NHS Trust, London, UK
- Department of Radiology, Imperial College London, London, UK
| |
Collapse
|
2
|
Mullane S, Michaelis K, Henrikson C, Iwai S, Miller C, Harrell C, Hayes D. Utilization and programming of an automatic MRI recognition feature for cardiac rhythm management devices. Heart Rhythm O2 2021; 2:132-137. [PMID: 34113915 PMCID: PMC8183951 DOI: 10.1016/j.hroo.2021.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Cardiac implantable electronic devices (CIED)—ie, pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices—have recently been designed to allow for patients to safely undergo magnetic resonance imaging (MRI) when specific programming is implemented. MRI AutoDetect is a feature that automatically switches CIED’s programming into and out of an MR safe mode when exposed to an MRI environment. Objective The purpose was to analyze de-identified daily remote transmission data to characterize the utilization of the MRI AutoDetect feature. Methods Home Monitoring transmission data collected from MRI AutoDetect–capable devices were retrospectively analyzed to determine the workflow and usage in patients experiencing an MRI using the MRI AutoDetect feature. Results Among 48,756 capable systems, 2197 devices underwent an MRI using the MRI AutoDetect feature. In these 2197 devices, the MRI AutoDetect feature was used a total of 2806 times with an average MRI exposure of 40.83 minutes. The majority (88.9%) of MRI exposures occurred on the same day as the MRI AutoDetect programming. A same day post-MRI exposure follow-up device interrogation was performed 8.6% of the time. A device-related complaint occurred within 30 days of the MRI exposure in 0.25% of MRI exposures using MRI AutoDetect but with no adverse clinical outcome. Conclusion As a result of automation in device programming, the MRI AutoDetect feature eliminated post-MRI device reprogramming in 91.4% of MRI exposures and, while less frequent, allowed for pre-MRI interrogations prior to the day of the MRI exposure—reducing resource utilization and creating workflow flexibility.
Collapse
Affiliation(s)
| | | | - Charles Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Sei Iwai
- Westchester Medical Center Health Network, Valhalla, New York.,New York Medical College, Valhalla, New York
| | | | | | | |
Collapse
|
3
|
Daghighi S, Chan A, Kiani Nazarlou A, Hasan Z, Halimi M, Akbarzadeh F, Kazemi D, Daghighi MH, Fouladi DF. Clinical and histopathological outcome of cervical and chest MRI involving non-MRI-conditional cardiac pacemakers: a study using sheep models. Radiol Med 2020; 125:706-714. [PMID: 32206985 DOI: 10.1007/s11547-020-01173-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 03/11/2020] [Indexed: 01/09/2023]
Abstract
AIM To examine the clinical and histopathological consequences of MRI in sheep implanted with non-MRI-conditional cardiac pacemakers. MATERIALS AND METHODS Under general anesthesia, active fixation leads of two dual-chamber, non-MRI-conditional cardiac pacemakers (St. Jude Medical and Medtronic) were implanted either at the right ventricular apex or at the right atrium of two male sheep and connected to the V and A channels of the pacemakers, respectively. The generators were placed in cervical subcutaneous pockets. On day 5, both sheep underwent 1.5 T cervical and chest MRI with continuous electrocardiogram monitoring. Obtained sequences were T1-weighted (T1W), T2-weighted (T2W), T2-gradient echo and diffusion weighted (DW). The employed modes were OVO, VOO and VVI for one sheep and OAO, AOO and AAI for the other (unipolar and bipolar configuration of pacing and sensing for both). Battery impedance, pacing lead impedance, intrinsic amplitude and capture thresholds were checked at baseline and after each sequence, as well as 48 h after imaging. Histopathological examination of the cardiac tissue around the lead tip was performed 4 weeks post-imaging. RESULTS No significant changes in device position or configuration were observed during or after MRI. Clinical outcome was uneventful in both sheep. Minor inflammatory and necrotic changes were reported after histopathological examination of the cardiac tissue around the lead tip. CONCLUSION 1.5 T MRI of two implanted non-MRI-conditional pacemakers was found safe in terms of device configuration and stability, clinical outcome and cardiac tissue histopathological findings.
Collapse
Affiliation(s)
- Shadi Daghighi
- Department of Radiology, University of California, San Diego, CA, USA
| | - Aimee Chan
- Department of Radiology, University of Toronto (Sunnybrook), Toronto, Ontario, Canada
| | - Ali Kiani Nazarlou
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Hasan
- Department of Pathology, University of Tennessee, Memphis, TN, USA
| | - Monireh Halimi
- Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariborz Akbarzadeh
- Department of Cardiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Davoud Kazemi
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | | | | |
Collapse
|
4
|
Bauer WR, Lau DH, Wollmann C, McGavigan A, Mansourati J, Reiter T, Frömer S, Ladd ME, Quick HH. Clinical safety of ProMRI implantable cardioverter-defibrillator systems during head and lower lumbar magnetic resonance imaging at 1.5 Tesla. Sci Rep 2019; 9:18243. [PMID: 31796767 PMCID: PMC6890633 DOI: 10.1038/s41598-019-54342-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/05/2019] [Indexed: 11/21/2022] Open
Abstract
Magnetic resonance imaging (MRI) has long been contraindicated in patients with implanted pacemakers, defibrillators, and cardiac resynchronisation therapy (CRT) devices due to the risk of adverse effects through electromagnetic interference. Since many recipients of these devices will have a lifetime indication for an MRI scan, the implantable systems should be developed as ‘MRI-conditional’ (be safe for the MRI environment under predefined conditions). We evaluated the clinical safety of several Biotronik ProMRI (‘MRI-conditional’) defibrillator and CRT systems during head and lower lumbar MRI scans at 1.5 Tesla. The study enrolled 194 patients at 22 sites in Australia, Canada, and Europe. At ≥9 weeks after device implantation, predefined, non-diagnostic, specific absorption rate (SAR)-intensive head and lower lumbar MRI scans (total ≈30 minutes per patient) were performed in 146 patients that fulfilled pre-procedure criteria. Three primary endpoints were evaluated: freedom from serious adverse device effects (SADEs) related to MRI and defibrillator/CRT (leading to death, hospitalisation, life-threatening condition, or potentially requiring implanted system revision or replacement), pacing threshold increase, and sensing amplitude decrease, all at the 1-month post-MRI clinical visit. No MRI-related SADE occurred. Lead values remained stable, measured in clinic and monitored daily by the manufacturer home monitoring technology.
Collapse
Affiliation(s)
- Wolfgang Rudolf Bauer
- Department of Internal Medicine I, Universitätsklinikum Würzburg, Würzburg, Germany.
| | - Dennis H Lau
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Christian Wollmann
- Department of Internal Medicine III, Universitätsklinikum St. Pölten, St. Pölten, Austria.,Institute of Cardiovascular Research, Karl-Landsteiner Society, St. Pölten, Austria
| | | | - Jacques Mansourati
- Hôpital de la Cavale Blanche, University Hospital of Brest and University of Western Brittany, Brest, France
| | - Theresa Reiter
- Department of Internal Medicine I, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Simone Frömer
- Centre for Clinical Research, BIOTRONIK SE & Co. KG, Berlin, Germany
| | - Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany.,Faculty of Physics and Astronomy and Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany.,Erwin L. Hahn Institute for MR Imaging, University Duisburg-Essen, Essen, Germany
| |
Collapse
|
5
|
AlRahabi MK, Ghabbani HM. Influence and safety of electronic apex locators in patients with cardiovascular implantable electronic devices: a systematic review. Libyan J Med 2019; 14:1547071. [PMID: 30458679 PMCID: PMC6249593 DOI: 10.1080/19932820.2018.1547071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/01/2018] [Indexed: 11/13/2022] Open
Abstract
The widespread use of cardiovascular implantable electronic devices has increased concerns regarding using electronic apex locators in patients with these devices. This systematic review investigated the effects and safety of using electronic apex locators in patients with cardiovascular implantable electronic devices. METHODS An electronic search in the Cochrane Library, PubMed (MEDLINE), ScienceDirect, and Scientific Electronic Library Online (Scielo) databases for relevant articles published between December 2000 and December 2018 was performed. The search strategy centered on terms related to electronic apex locators use during root canal treatment in patients with cardiovascular implantable electronic devices. RESULTS Seven studies (five in vitro and two in vivo) fulfilled the inclusion criteria for this review. It was found that electronic apex locators can be used safely in patients with cardiovascular implantable electronic devices, when general precautions are followed. CONCLUSIONS Although the present review suggests that electronic apex locators can be used safely in patients with implantable cardioverter defibrillators, consultation with patients' cardiologists remains advisable.
Collapse
Affiliation(s)
| | - Hani M. Ghabbani
- College of Dentistry, Taibah University, Madinah Al Munawwarah, Saudi Arabia
| |
Collapse
|
6
|
Bhuva AN, Moralee R, Moon JC, Manisty CH. Making MRI available for patients with cardiac implantable electronic devices: growing need and barriers to change. Eur Radiol 2019; 30:1378-1384. [PMID: 31776746 PMCID: PMC7033076 DOI: 10.1007/s00330-019-06449-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/02/2019] [Accepted: 09/12/2019] [Indexed: 11/22/2022]
Abstract
Abstract More than half of us will need a magnetic resonance imaging (MRI) scan in our lifetimes. MRI is an unmatched diagnostic test for an expanding range of indications including neurological and musculoskeletal disorders, cancer diagnosis, and treatment planning. Unfortunately, patients with cardiac pacemakers or defibrillators have historically been prevented from having MRI because of safety concerns. This results in delayed diagnoses, more invasive investigations, and increased cost. Major developments have addressed this—newer devices are designed to be safe in MRI machines under specific conditions, and older legacy devices can be scanned provided strict protocols are followed. This service however remains difficult to deliver sustainably worldwide: MRI provision remains grossly inadequate because patients are less likely to be referred, and face difficulties accessing services even when referred. Barriers still exist but are no longer technical. These include logistical hurdles (poor cardiology and radiology interaction at physician and technician levels), financial incentives (re-imbursement is either absent or fails to acknowledge the complexity), and education (physicians self-censor MRI requests). This article therefore highlights the recent changes in the clinical, logistical, and regulatory landscape. The aim of the article is to enable and encourage healthcare providers and local champions to build MRI services urgently for cardiac device patients, so that they may benefit from the same access to MRI as everyone else. Key Points • There is now considerable evidence that MRI can be provided safely to patients with cardiac implantable electronic devices (CIEDs). However, the volume of MRI scans delivered to patients with CIEDs is fifty times lower than that of the estimated need, and patients are approximately fifty times less likely to be referred. • Because scans for this patient group are frequently for cancer diagnosis and treatment planning, MRI services need to develop rapidly, but the barriers are no longer technical. • New services face logistical, educational, and financial hurdles which can be addressed effectively to establish a sustainable service at scale.
Collapse
Affiliation(s)
- A N Bhuva
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK. .,Institute for Cardiovascular Science, University College London, London, UK.
| | - R Moralee
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK
| | - J C Moon
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK.,Institute for Cardiovascular Science, University College London, London, UK
| | - C H Manisty
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London, EC1A 7BE, UK.,Institute for Cardiovascular Science, University College London, London, UK
| |
Collapse
|
7
|
Feasibility, safety, and utility of brain MRI for patients with non-MRI-conditioned CIED. Neurosurg Rev 2019; 43:1539-1546. [PMID: 31624965 DOI: 10.1007/s10143-019-01149-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 10/25/2022]
Abstract
Feasibility, safety, and utility of brain MRI for patients with non-MRI-conditioned cardiac implantable electrical devices (CIEDs) remains controversial. While a growing number of studies have shown safe employment in select patients under strict protocols, there is an increasing clinical need for further off-label investigations. To assess the feasibility and utility of brain MRI in neurological and neurosurgical patients with non-MRI-conditioned CIEDs using off-label protocol. We retrospectively evaluated 126 patients with non-MRI-conditioned CIEDs referred to our hospital between 2014 to 2018 for MRI under an IRB-approved protocol. A total of 126 off-label brain MRI scans were performed. The mean age was 67.5 ± 13.0. Seventy percent of scans were performed on female patients. Indications for MRI are neurosurgical (45.2%), neurological (51.6%), and others (3.2%). MRI utilization for tumor cases was highest for tumor cases (68.3%), but employment was valuable for vascular (12.7%), deep brain stimulators (3.2%), and other cases (15.9%). In the tumor category, (37.2%) of the scans were performed for initial diagnosis and pre-surgical planning, (47.7%) for post-intervention evaluation/surveillance, (15.1%) for stereotactic radiosurgery treatment (CyberKnife). No clinical complications were encountered. No functional device complications of the CIED were identified during and after the MRI in 96.9% of the studies. A 49.6% of the off-label brain MRI scans performed led to a clinically significant decision and/or intervention for the patients. A 42.9% of obtained MRI studies did not change the plan of care. A 7.9% of post-scan decision-making data was not available. We demonstrate that off-label brain MRI scans performed on select patients under a strict protocol is feasible, safe, and relevant. Almost 50% of scans provided critical information resulting in clinical intervention of the patients.
Collapse
|
8
|
Bhuva AN, Feuchter P, Hawkins A, Cash L, Boubertakh R, Evanson J, Schilling R, Lowe M, Moon JC, Manisty CH. MRI for patients with cardiac implantable electronic devices: simplifying complexity with a 'one-stop' service model. BMJ Qual Saf 2019; 28:853-858. [PMID: 30760606 PMCID: PMC6837254 DOI: 10.1136/bmjqs-2018-009079] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/11/2019] [Accepted: 01/18/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patients with cardiac pacemakers and defibrillators are disadvantaged because of poor access to MRI scans, leading to late and misdiagnosis particularly for cancer and neurological disease. New technology allied to tested protocols now allows safe MRI scanning of such patients; however, logistical barriers persist. AIM To deliver a streamlined sustainable service that provides timely MRI scans to patients with cardiac implantable electronic devices (CIEDs). METHODS Patients requested a 'one-stop' service for MRI, whereby devices could be reprogrammed and scans acquired at a single location and visit. To provide this 'one-stop' service, we trained a team including administrators, physicians, cardiac physiologists and radiographers. A standard protocol was used to prevent unnecessary request refusals and delays to scheduling. Service volume, waiting time and safety were analysed 6 months before and 2 years after service redesign. Waiting times for internal and external inpatient referrals plus time to treatment for patients on a cancer pathway were analysed. RESULTS 215 MRI scans were performed over 2 years. After service redesign, MRI provision increased six-fold to 20 times the national average with reduced waiting time from 60 to 15 days and no adverse events. Departmental throughput was maintained. 85 (40%) referrals were external. 41 (19%) inpatients were scanned, reducing bed-stay by 3 days for internal referrals. 24 (11%) scans were for suspected cancer, 83% allowed treatment within the national standard of 62 days. There was no preintervention service for either inpatients or suspected cancer investigation. CONCLUSION Implementation of a 'one-stop' service model to provide MRI for patients with CIEDs is safe, streamlined, scalable and has reduced delays making economic and clinical sense. Protocols and checklists are available at mrimypacemaker.com.
Collapse
Affiliation(s)
- Anish N Bhuva
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Patricia Feuchter
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Angela Hawkins
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Lizette Cash
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Redha Boubertakh
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Jane Evanson
- Department of Radiology, Barts Health NHS Trust, London, UK
| | - Richard Schilling
- Department of Cardiac Electrophysiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Martin Lowe
- Department of Cardiac Electrophysiology, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - James C Moon
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Charlotte H Manisty
- Department of Cardiac Imaging, Barts Heart Centre, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| |
Collapse
|
9
|
Provision of MR imaging for patients with cardiac implantable electronic devices (CIEDs): a single-center experience and national survey. Ir J Med Sci 2018; 188:999-1004. [PMID: 30368645 DOI: 10.1007/s11845-018-1922-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Patients with cardiac implantable electronic devices (CIEDs) were traditionally denied access to MR imaging due to safety concerns. AIMS The aim of this study was to review a single-center experience of MR imaging at 1.5T of patients with CIEDs and survey national availability of this service. METHODS Three hundred thirty-four patients with CIEDs were included in the review. Two hundred nine patients did not progress to MRI due to non MR-conditional CIEDs, retained pacing leads, recent implant insertion, and other patient factors. A record was made of CIED type, number of body parts imaged, numbers of repeat studies and complications. All devices were scanned with cardiology involvement. RESULTS One hundred twenty-five patients, 90 males, 35 females, aged 20-91 years progressed to MR imaging. Eighty-six patients had pacemakers, 15 had implantable cardioverter devices (ICDs), and 24 had implantable loop recorders (ILRs). Twenty-one patients had more than one body part scanned. Regions scanned included spine n = 82, joints n = 42, head n = 40, heart n = 8, and abdomen/pelvis n = 13. Twenty-six patients had multiple separate MR studies (range 2-6). Three complications included diaphragmatic stimulation when the device was switched to MR-conditional mode resulting in scan abandonment, device failure post-MRI requiring manufacturer reprogramming, and patient dizziness post reprogramming requiring cardiology review. One cardiac study was non-diagnostic due to artifact from a low left-sided ICD. Imaging of patients with pacemakers is available in 14 of 42 (38%) hospitals with MR units nationally. CONCLUSION MR-conditional CIEDs can be safely scanned with diagnostic quality at 1.5T using a protocol involving radiology and cardiology.
Collapse
|
10
|
Jung JI. Magnetic Resonance Imaging for Patients with Cardiac Implantable Electronic Devices: Reduced Concerns Regarding Safety, but Scrutiny Remains Critical. Korean Circ J 2016; 46:765-767. [PMID: 27826333 PMCID: PMC5099330 DOI: 10.4070/kcj.2016.46.6.765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/11/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- Jung Im Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|