MRI examinations were performed safely with zero patient- or device-related complications in 532 patients with non-MRI-conditional cardiac devices, including those who were pacemaker-dependent or had abandoned leads.
Observational (n=532)
No
Does MRI examination cause complications and provide clinical utility in patients with non-MRI-conditional cardiac devices?
MRI examinations can be performed safely in patients with non-MRI-conditional cardiac devices and frequently lead to changes in clinical management.
Purpose To explore the safety and clinical utility of MRI in participants with non–MRI-conditional cardiac implantable electronic devices, by establishing the Patient Registry of Magnetic Resonance Imaging in Non-Approved DEvices (PROMeNADe). Materials and Methods From September 2015 to June 2019, 532 participants (211 women) with a mean age of 69 years ± 14 (standard deviation) were enrolled prospectively in the PROMeNADe registry (ClinicalTrials.gov identifier: NCT03081364) and underwent a total of 608 MRI examinations (61 cardiac MRI examinations). All participants had device interrogations performed before and after each MRI. Pacemaker-dependent patients received asynchronous pacing. Patients with an implantable cardioverter defibrillator (ICD) had tachycardia therapies disabled during the MRI. An electrophysiology nurse monitored participants for any hemodynamic or rhythm abnormalities. Referring physicians were surveyed regarding the clinical utility of the MRI. Standard descriptive analyses included summary statistics with percentages and means. Results Cardiac devices included pacemakers (46%), ICDs (30%), cardiac resynchronization therapy (CRT) pacemakers (4%), and CRT defibrillators (17%), as well as abandoned leads (2%). Pacemaker-dependent patients comprised 27% of all MRI examinations. There were no patient- or device-related complications. Clinical utility surveys of MRI examinations were completed by 150 physicians. According to the survey responses, these MRI examinations changed the suspected diagnosis 25% of the time and changed suspected prognosis in 26% of participants, with planned medical or surgical treatment being changed 42% of the time. Conclusion This registry demonstrates that MRI examinations, including thoracic MRI examinations, can be performed safely in patients who have non–MRI-conditional devices, in pacemaker-dependent patients with ICDs, and in patients with abandoned leads. These MRI examinations can have a substantial impact on patient care, justifying the extensive resources used to perform them. Supplemental material is available for this article. Keywords: Adults, Cardiac, Heart, MR-Imaging, Safety © RSNA, 2020 See also the commentary by Peshock in this issue.
Gupta et al. (Thu,) conducted a observational in Non-MRI-conditional cardiac implantable electronic devices (n=532). 1.5-T MRI examination was evaluated on Adverse device events or adverse patient events. MRI examinations were performed safely with zero patient- or device-related complications in 532 patients with non-MRI-conditional cardiac devices, including those who were pacemaker-dependent or had abandoned leads.