Mortality After Magnetic Resonance Imaging of the Brain in Patients With Cardiovascular Implantable Devices

Deepak Padmanabhan, Mary L. Jondal, David O. Hodge, Ramila A. Mehta, Nancy G. Acker, Connie M. Dalzell, Suraj Kapa, Samuel J. Asirvatham, Yong Mei Cha, Joel P Felmlee, Robert E. Watson, Paul A. Friedman

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

BACKGROUND: Use of magnetic resonance imaging (MRI) brain is restricted in patients with cardiovascular implantable electronic devices (CIEDs). We proposed to determine whether mortality difference exists for patients with non-MRI-conditional CIEDs undergoing brain MRI compared with controls. METHODS AND RESULTS: Retrospective analysis of prospectively collected data was performed to compare all-cause mortality in patients with CIEDs undergoing brain MRI (CIED-MRI) with 3 control groups matched for age, sex, imaging year, and type of CIED: (1) no CIED, brain MRI (no-CIED-MRI); (2) CIED, brain computerized tomography (CT) scan (CIED-CT); and (3) no CIED, brain CT (no-CIED-CT). The primary outcome was a significant difference (P<0.05) between estimated mortality rates. Secondary outcomes were changes in device function before and after brain MRI. The estimated all-cause mortality at 5 years for the CIED-MRI group [mean age (±SD), 68.2 years (15.3 years); 61.2% men] was not significantly different from patients who underwent CT with or without a device (CIED-CT group: hazard ratio, 0.814; 95% confidence interval, 0.593-1.117; P=0.2; no-CIED-CT group: hazard ratio, 1.149; 95% confidence interval, 0.818-1.613; P=0.4). There was a significant increase in mortality between CIED-MRI and no-CIED-MRI groups (hazard ratio, 1.463; 95% confidence interval, 1.019-2.099; P=0.04). CONCLUSIONS: Brain MRI in patients with CIEDs does not carry an increased mortality risk compared with brain CT and can be performed with adherence to appropriate procedural protocols.

Original languageEnglish (US)
Pages (from-to)e005480
JournalCirculation. Arrhythmia and electrophysiology
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • cardiac implantable electronic devices
  • computed tomography
  • magnetic resonance imaging
  • mortality
  • outcomes
  • power on reset

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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