Prospective evaluation of the utility of magnetic resonance imaging in patients with non-MRI-conditional pacemakers and defibrillators

Deepak Padmanabhan, Danesh Kella, Ameesh Isath, Nidhi Tandon, Siva Mulpuru, Abhishek Deshmukh, Suraj Kapa, Ramila Mehta, Connie Dalzell, Nora Olson, Joel Felmlee, Mary L. Jondal, Samuel J. Asirvatham, Robert E. Watson, Yong M. Cha, Paul Friedman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Magnetic resonance imaging (MRI) in patients with legacy cardiovascular implantable electronic devices (CIEDs) in situ is likely underutilized. We hypothesized the clinical benefit of MRI would outweigh the risks in legacy CIED patients. Methods: This is a single-center retrospective study that evaluated and classified the utility of MRI using a prospectively maintained database. The outcomes were classified as aiding in diagnosis, treatment, or both for the patients attributable to the MRI. We then assessed the incidence of adverse effects (AE) when the MRI was performed. Results: In 668, MRIs performed on 479 patients, only 13 (1.9%) MRIs did not aid in the diagnosis or treatment of the patient. Power-on reset events without clinical sequelae in three scans (0.45%) were the only AE. The probability of an adverse event happening without any benefit from the MRI scan was 1.1 × 10−4. A maximum benefit in diagnosis using MRI was obtained in ruling out space-occupying lesions (121/185 scans, 65.4%). Scans performed in patients for elucidating answers to queries in treatment were most frequently done for disease staging at long term follow-up (167/470 scans, 35.5%). Conservative treatment (184/470 scans, 39%) followed by medication changes (153/470 scans, 28.7%) were the most common treatment decisions made. Conclusions: The utility of MRI in patients with non-MRI-conditional CIEDs far outweighs the risk of adverse events when imaging is done in the context of a multidisciplinary program that oversees patient safety.

Original languageEnglish (US)
Pages (from-to)2931-2939
Number of pages9
JournalJournal of cardiovascular electrophysiology
Volume31
Issue number11
DOIs
StatePublished - Nov 1 2020

Keywords

  • MRI utility
  • cardiovascular implantable electronic devices
  • magnetic resonance imaging
  • non-MRI-conditional devices
  • power-on reset

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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