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 Andrew Friedman

Research output: Contribution to journalArticle

2 Citations (Scopus)

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

Fingerprint

Magnetic Resonance Imaging
Equipment and Supplies
Mortality
Brain
Tomography
Confidence Intervals
Age Groups
Control Groups

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)

Cite this

Mortality After Magnetic Resonance Imaging of the Brain in Patients With Cardiovascular Implantable Devices. / Padmanabhan, Deepak; Jondal, Mary L.; Hodge, David O.; Mehta, Ramila A.; Acker, Nancy G.; Dalzell, Connie M.; Kapa, Suraj; Asirvatham, Samuel J; Cha, Yong-Mei; Felmlee, Joel P.; Watson, Robert E.; Friedman, Paul Andrew.

In: Circulation. Arrhythmia and electrophysiology, Vol. 11, No. 1, 01.01.2018, p. e005480.

Research output: Contribution to journalArticle

Padmanabhan, Deepak ; Jondal, Mary L. ; Hodge, David O. ; Mehta, Ramila A. ; Acker, Nancy G. ; Dalzell, Connie M. ; Kapa, Suraj ; Asirvatham, Samuel J ; Cha, Yong-Mei ; Felmlee, Joel P. ; Watson, Robert E. ; Friedman, Paul Andrew. / Mortality After Magnetic Resonance Imaging of the Brain in Patients With Cardiovascular Implantable Devices. In: Circulation. Arrhythmia and electrophysiology. 2018 ; Vol. 11, No. 1. pp. e005480.
@article{2cee99aa29b248bd872034f63c7809a9,
title = "Mortality After Magnetic Resonance Imaging of the Brain in Patients With Cardiovascular Implantable Devices",
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.",
keywords = "cardiac implantable electronic devices, computed tomography, magnetic resonance imaging, mortality, outcomes, power on reset",
author = "Deepak Padmanabhan and Jondal, {Mary L.} and Hodge, {David O.} and Mehta, {Ramila A.} and Acker, {Nancy G.} and Dalzell, {Connie M.} and Suraj Kapa and Asirvatham, {Samuel J} and Yong-Mei Cha and Felmlee, {Joel P.} and Watson, {Robert E.} and Friedman, {Paul Andrew}",
year = "2018",
month = "1",
day = "1",
doi = "10.1161/CIRCEP.117.005480",
language = "English (US)",
volume = "11",
pages = "e005480",
journal = "Circulation: Arrhythmia and Electrophysiology",
issn = "1941-3149",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Mortality After Magnetic Resonance Imaging of the Brain in Patients With Cardiovascular Implantable Devices

AU - Padmanabhan, Deepak

AU - Jondal, Mary L.

AU - Hodge, David O.

AU - Mehta, Ramila A.

AU - Acker, Nancy G.

AU - Dalzell, Connie M.

AU - Kapa, Suraj

AU - Asirvatham, Samuel J

AU - Cha, Yong-Mei

AU - Felmlee, Joel P.

AU - Watson, Robert E.

AU - Friedman, Paul Andrew

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - cardiac implantable electronic devices

KW - computed tomography

KW - magnetic resonance imaging

KW - mortality

KW - outcomes

KW - power on reset

UR - http://www.scopus.com/inward/record.url?scp=85059199640&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059199640&partnerID=8YFLogxK

U2 - 10.1161/CIRCEP.117.005480

DO - 10.1161/CIRCEP.117.005480

M3 - Article

C2 - 29321191

AN - SCOPUS:85059199640

VL - 11

SP - e005480

JO - Circulation: Arrhythmia and Electrophysiology

JF - Circulation: Arrhythmia and Electrophysiology

SN - 1941-3149

IS - 1

ER -