Key result
3T MRI did not cause any adverse clinical events in patients with either '3T MRI-conditional' or 'non-3T MRI-conditional' cardiac implantable electronic devices.
Why the study?
Owing to potential magnetic field interactions, 3 Tesla MRI is largely withheld from patients with CIEDs despite providing critical imaging information for many conditions.
Does 3 Tesla MRI safely avoid clinical adverse events and device malfunctions in patients with cardiac implantable electronic devices?
Cohort (n=97)
No
Does 3 Tesla MRI safely avoid clinical adverse events and device malfunctions in patients with cardiac implantable electronic devices?
Absolute Event Rate: 0% vs 0%
This study suggests that clinically indicated 3T MRI scans can be safely performed in patients with both conditional and non-conditional cardiac implantable electronic devices without major adverse events.
Supports 3T MRI safety in CIED patients including non-conditional devices; leaves open randomized confirmation before practice change.
AIMS: Three Tesla (T) magnetic resonance imaging (MRI) provides critical imaging information for many conditions. Owing to potential interactions of the magnetic field, it is largely withheld from patients with cardiac implantable electronic devices (CIEDs). Therefore, we assessed the safety of 3T MRI in patients with '3T MRI-conditional' and 'non-3T MRI-conditional' CIEDs. METHODS AND RESULTS: We performed a retrospective single-centre analysis of clinically indicated 3T MRI examinations in patients with conventional pacemakers, cardiac resynchronization devices, and implanted defibrillators from April 2020 to May 2022. All CIEDs were interrogated and programmed before and after scanning. Adverse events included all-cause death, arrhythmias, loss of capture, inappropriate anti-tachycardia therapies, electrical reset, and lead or generator failure during or shortly after MRI. Changes in signal amplitude and lead impedance were systematically assessed. Statistics included median and interquartile range. A total of 132 MRI examinations were performed on a 3T scanner in 97 patients. Thirty-five examinations were performed in patients with 'non-3T MRI-conditional' CIEDs. Twenty-six scans were performed in pacemaker-dependent patients. No adverse events occurred during or shortly after MRI. P-wave or R-wave reductions ≥ 50 and ≥ 25%, respectively, were noted after three (2.3%) scans, all in patients with '3T MRI-conditional' CIEDs. Pacing and shock impedance changed by ± 30% in one case (0.7%). Battery voltage and stimulation thresholds did not relevantly change after MRI. CONCLUSION: Pending verification in independent series, our data suggest that clinically indicated MRI scans at 3T field strength should not be withheld from patients with cardiac pacemakers or defibrillators.
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Fluschnik et al. (2022) conducted a cohort in Cardiac implantable electronic devices (CIEDs) (n=97). 3 Tesla (3T) magnetic resonance imaging (MRI) vs. Pre-MRI baseline device function was evaluated on Adverse events (all-cause death, arrhythmias, loss of capture, inappropriate anti-tachycardia therapies, electrical reset, lead or generator failure). 3T MRI did not cause any adverse clinical events in patients with either '3T MRI-conditional' or 'non-3T MRI-conditional' cardiac implantable electronic devices.
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