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Safety of serial MRI in patients with implantable cardioverter defibrillators
  1. M Juhani Junttila1,
  2. Joel E Fishman2,3,
  3. Gustavo A Lopera1,2,
  4. Pradip M Pattany2,3,
  5. Darcy L Velazquez2,
  6. Adam R Williams2,
  7. Barry H Trachtenberg1,2,3,
  8. Cristina Sanina2,
  9. Jacques Mather2,3,
  10. Joshua M Hare1,2,3
  1. 1Division of Cardiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
  2. 2Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA
  3. 3Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
  1. Correspondence to Dr Joshua M Hare, Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, 1501 NW 10th Street, Suite 824, Miami, FL 33136, USA; jhare{at}med.miami.edu

Abstract

Objective While patients with cardiac implantable electronic devices could benefit from magnetic resonance (MR) imaging, the presence of such devices has been designated as an absolute contraindication to MR. Although scanning algorithms are proposed for cardiac implantable electronic devices, their safety remains uncertain. To address this issue, the safety of serial cardiac MR scans was evaluated in patients with implantable cardioverter defibrillators (ICDs).

Methods Three serial cardiac MR scans were prospectively performed at 1.5 T on 10 patients (9 men) of median age 56 years (range 51–68) with ICDs. ICD interrogation was performed before and after the MR scan and at a follow-up of median 370 days (range 274–723). Image quality was also assessed.

Results In all patients MR scanning occurred without complications. There were no differences between pre- and post-MR pacing capture threshold, pacing lead or high voltage lead impedance, or battery voltage values. During follow-up there were no occurrences of ICD dysfunction. Although most patients had image artifacts, the studies were generally diagnostic regarding left ventricular function and wall motion. Delayed enhancement imaging was of good quality for inferior wall and inferolateral infarcts, but ICD artifacts often affected the imaging of anterior wall infarcts.

Conclusion Serial MR scans at 1.5 T in patients with ICDs, when carefully performed in a monitored setting, have no adverse effects on either patient or device. When required, single or multiple MR scans at 1.5 T may therefore be considered for clinical diagnostic purposes in these patients.

  • Implantable cardioverter defibrillator
  • MRI
  • channelopathy
  • sudden cardiac death
  • gene association
  • heart failure
  • cardiomyopathy dilated
  • myocardial ischaemia and infarction (IHD)
  • cardiomyoplasty
  • surgery-coronary bypass
  • minimally invasive
  • heart transplant
  • cardiac remodelling
  • heart failure
  • arrhythmias
  • defibrillation
  • pacemakers
  • heart failure treatment
  • nitric oxide
  • cardiomyopathy dilated

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Footnotes

  • Funding This study was supported by Fondation Leducq, Paris, France (MJJ) and by National Heart, Lung, and Blood Institute grants U54-HL081028 (Specialised Center for Cell Based Therapy), R01-HL084275 and P20 HL101443. JMH is also supported by RO1's AG025017, HL065455 and HL094849. This work was also supported by UHealth at the Miller School of Medicine and the Interdisciplinary Stem Cell Institute of the Miller School of Medicine, University of Miami, Miami, Florida, USA.

  • Competing interests None.

  • Ethics approval This study was approved by the institutional review board of the University of Miami.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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