Magnetic resonance imaging (MRI) offers unrivaled soft tissue resolution and multiplanar
imaging capabilities. Cardiac MRI is capable of accurate characterization of cardiac
function and is uniquely capable of identifying scar fibrosis and fat deposition,
thus making it an ideal imaging modality for the evaluation of patients presenting
with arrhythmia. In addition, the absence of x-ray radiation makes MRI suitable for
follow-up of chronic disease and for imaging in young patients and women of childbearing
age. Due to the ever expanding indications for implantation of permanent pacemakers
and implantable cardioverter-defibrillators (ICDs), advancing severity of disease
and age of the population, and advances in device technology, the number of patients
with implantable cardiac devices will continue to increase. It has been estimated
that each patient with a pacemaker or ICD has a 50% to 75% likelihood of having a
clinical indication for MRI over the lifetime of their device. When performed with
appropriate supervision and following a protocol for safety, many studies over the
past 10 years have reported the safety of MRI with selected devices. However, catastrophic
complications with older devices have been reported. Familiarity with each device
class and its potential for electromagnetic interaction is essential for electrophysiologists
whose patients may require MRI.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart RhythmAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Modern pacemaker and implantable cardioverter/defibrillator systems can be magnetic resonance imaging safe: in vitro and in vivo assessment of safety and function at 1.5 T.Circulation. 2004; 110: 475-482
- Determinants of gradient field-induced current in a pacemaker lead system in a magnetic resonance imaging environment.Heart Rhythm. 2008; 5: 462-468
- Safe scanning, but frequent artifacts mimicking bradycardia and tachycardia during magnetic resonance imaging (MRI) in patients with an implantable loop recorder (ILR).Ann Noninvas Electrocardiol. 2005; 10: 404-408
- Effects of magnetic resonance imaging on cardiac pacemakers and electrodes.Am Heart J. 1997; 134: 467-473
- Clinical utility and safety of a protocol for noncardiac and cardiac magnetic resonance imaging of patients with permanent pacemakers and implantable-cardioverter defibrillators at 1.5 Tesla.Circulation. 2006; 114: 1277-1284
- Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention: endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance.Circulation. 2007; 116: 2878-2891
- Safe performance of magnetic resonance imaging on five patients with permanent cardiac pacemakers.Pacing Clin Electrophysiol. 1996; 19: 913-919
- MR imaging and cardiac pacemakers: in-vitro evaluation and in-vivo studies in 51 patients at 0.5 T.Radiology. 2000; 215: 869-879
- Interference with cardiac pacemakers by magnetic resonance imaging: are there irreversible changes at 0.5 Tesla?.Pacing Clin Electrophysiol. 2001; 24: 489-495
- Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla.J Am Coll Cardiol. 2004; 43: 1315-1324
- Is magnetic resonance imaging safe in cardiac pacemaker recipients?.Pacing Clin Electrophysiol. 2005; 28: 274-278
- Outcome of magnetic resonance imaging (MRI) in selected patients with implantable cardioverter defibrillators (ICDs).Pacing Clin Electrophysiol. 2005; 28: 270-273
- Strategy for safe performance of extrathoracic magnetic resonance imaging at 1.5 tesla in the presence of cardiac pacemakers in non-pacemaker-dependent patients: a prospective study with 115 examinations.Circulation. 2006; 114: 1285-1292
Article info
Publication history
Published online: October 24, 2008
Footnotes
Dr. Halperin is a scientific advisor for Boston Scientific Inc. The Johns Hopkins University Advisory Committee on Conflict of Interest manages all commercial arrangements.
Identification
Copyright
© 2009 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
