Uses and potential for cardiac magnetic resonance imaging in patients with cardiac resynchronisation pacemakers

INTRODUCTION: Cardiac magnetic resonance (CMR) imaging has been shown to be safe as an imaging modality for patients with cardiac resynchronization (CRT) devices. As a widely accepted method of measuring cardiac volumes, mass, and ejection fraction, CMR has become a core part of the diagnostic panel. A number of studies have already highlighted a role in optimizing left ventricular lead placemen with evidence that scanning is useful prior to implantation to predict outcomes and optimizing device effect. By balancing the considerations of CMR with the benefits, there may be further applications. AREAS COVERED: The aim of the review is to discuss the applications of CMR pre and post CRT implantation with an exploration into the future utility of this imaging modality. EXPERT OPINION: CMR has underutilized potential in improving diagnostics and care for patients implanted with CRT devices. Scanning patients post CRT implantation is not conducted routinely despite multiple potential applications. By employing modern technology and techniques, there is scope to improve CMR utility postimplantation by scanning at higher field strengths whilst CRT is active. We believe CMR has utility with advances expected to translate to improved treatment response and clinical outcomes.