12-lead ECG Recording in Patients with Cardiac Devices Undergoing a Cardiac MRI Scan – Initial Experiences

Motivation: Recording diagnostic 12-lead ECGs during CMR is challenging. Advancements of MR-compatible 12-lead ECG systems facilitate improved monitoring and prospect of simultaneous ECG recording and image acquisition, yet real-world data are lacking. Goal(s): We assess the feasibility and diagnostic quality of continuous 12-lead ECGs in two CIED patients during 1.5T CMR. Approach: Continuous 12-lead ECG recordings were obtained in one pacemaker and one ICD patient during 1.5T CMR, assessing signal quality and ECG SNR fluctuations across different sequences. Results: Clinically useful ECGs were obtained despite gradient-induced noise reflected in the drop in SNR on the ECG, indicating sequence-specific filtering could enhance MR-compatible ECG performance. Impact: This pilot study presents the first real-world clinical application of MR-compatible 12-lead ECG for routine CIED patient monitoring and highlights the need for tailored filtering solutions to mitigate MRI sequence-induced noise and improve patient monitoring during CMR.