Arrhythmias and conduction disturbancesDetermining the Risks of Magnetic Resonance Imaging at 1.5 Tesla for Patients With Pacemakers and Implantable Cardioverter Defibrillators
Section snippets
Methods
Medical records were reviewed for all patients with permanent pacemakers and ICDs who underwent clinically necessary MRIs from February 2006 to March 2009 at a single institution (the MRI group). MRI was ordered by the patient's treating physician, who determined that there was no acceptable alternative imaging study and that the potential benefit of the diagnostic data obtained by MRI significantly outweighed the potential risk for device failure. Patients who were pacemaker dependent
Results
In the MRI group, 109 patients with pacemakers and ICDs underwent 125 consecutive, clinically indicated MRI studies. A single scan was performed in 95 patients, 12 underwent 2 separate studies on different days, and 2 patients underwent 3 studies on different days. Three patients entered the scanner and were exposed to the static magnet field but did not undergo successful imaging (claustrophobia in 1 patient, unacceptable artifact from a biventricular ICD in 1 patient, and a pacemaker magnet
Discussion
No patient with a permanent pacemaker or ICD who underwent MRI experienced a primary end point event. With respect to our secondary end points, a small number of clinically relevant changes in device parameter measurements were noted. However, these changes were similar to a control group of patients who did not undergo MRI. Only 1 patient required temporary device reprogramming at the time of MRI. For all parameters measured, we selected limiting values that would distinguish between
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This study was funded by a Scripps Clinical Research Development Award, La Jolla, California, and philanthropic grants from the R. E. Hazard, Jr, family, Rancho Santa Fe, California, the Louis Grubb family, Scottsdale, Arizona, the Richard Deihl family, Rancho Santa Fe, California, and the Shultz Steel Company, Long Beach, California. Dr. Cohen was supported by a clinical research fellowship award from the Hewitt Foundation for Medical Research, Newport Beach, California.