Key result
Among 262 MRI scans in patients with MR-conditional cardiac devices, no life-threatening adverse events occurred, although 3 scans were mistakenly performed without setting the device to MRI mode.
Why the study?
Because MRI settings vary by device and require specific precautions and mode selection for safe examination, the authors examined the current status and issues regarding MRI examinations in patients with an MRI-conditional CIED.
Is MRI scanning safe and what are the practical issues encountered in patients with MR-conditional CIEDs?
Observational (n=162)
No
Is MRI scanning safe and what are the practical issues encountered in patients with MR-conditional CIEDs?
MRI scanning in patients with MR-conditional CIEDs is generally safe, but strict adherence to pre-scan device programming and intra-scan monitoring is essential to prevent potentially harmful incidents.
Demands strict MRI protocol adherence in CIED patients; observational data leave open definitive safety claims.
Objective Following the introduction of magnetic resonance (MR)-conditional cardiac implantable electrical devices (CIEDs), patients with CIEDs have undergone MRI scanning more frequently. As the required settings of MRI equipment for scanning patients with a CIED vary by device, a number of precautions should be taken to allow safe examinations, including the confirmation of conditions and selection of MRI modes appropriate for pacing status in individual patients. In this study, we examined the current status and issues concerning the performance of MRI examinations in patients with an MRI-conditional CIED. Method and Results We reviewed a total of 262 MRI scans. The most common site of MRI scanning was the head, followed by the spine, abdomen, and heart in order. Regarding the MRI mode, DOO was most often used, followed by OFF, AOO, and finally VOO mode, to maintain atrioventricular synchrony. Although no obvious adverse events were observed related to MRI scanning, there were several cases encountered that might have been predisposed to a significant incident or in which the patient's intrinsic pulse rates or subjective symptoms changed before and during scanning. Conclusion As MRI is a very useful diagnostic tool for cerebrovascular diseases and orthopedic disorders, the demand for MRI scanning is high when treating these areas. Although MRI scanning in patients with MR-conditional devices was performed without any adverse events, there were incidents that could have potentially led to major harm. This highlights the importance of confirming the appropriate MRI mode is being used before scanning and monitoring patients during scanning.
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Ikeya et al. (2021) conducted an observational in MR-conditional cardiac implantable electrical devices (n=162). Magnetic resonance imaging (MRI) was evaluated on Life-threatening adverse events related to MRI scanning. Among 262 MRI scans in patients with MR-conditional cardiac devices, no life-threatening adverse events occurred, although 3 scans were mistakenly performed without setting the device to MRI mode.
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