Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator

• Published in: The New England journal of medicine Vol. 376; no. 8; pp. 755 - 764
• Main Authors: Russo, Robert J, Costa, Heather S, Silva, Patricia D, Anderson, Jeffrey L, Arshad, Aysha, Biederman, Robert W.W, Boyle, Noel G, Frabizzio, Jennifer V, Birgersdotter-Green, Ulrika, Higgins, Steven L, Lampert, Rachel, Machado, Christian E, Martin, Edward T, Rivard, Andrew L, Rubenstein, Jason C, Schaerf, Raymond H.M, Schwartz, Jennifer D, Shah, Dipan J, Tomassoni, Gery F, Tominaga, Gail T, Tonkin, Allison E, Uretsky, Seth, Wolff, Steven D
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 23.02.2017
• Subjects: Adult; Aged; Aged, 80 and over; Arrhythmia; Atrial Fibrillation - etiology; Atrial Flutter - etiology; Contraindications; Defibrillators, Implantable; Equipment Failure; Female; Fibrillation; Humans; Magnetic fields; Magnetic resonance imaging; Magnetic Resonance Imaging - adverse effects; Male; Middle Aged; NMR; Nuclear magnetic resonance; Pacemaker, Artificial; Pacemakers; Patients; Prospective Studies; Registries; Scanning; Ventricle; United States > US
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1603265

A total of 1500 nonthoracic MRI examinations were performed on patients with a non–MRI-conditional pacemaker or ICD, after programming of the devices in accordance with a standardized protocol. No patient whose device was appropriately programmed had device or lead failure. The use of magnetic resonance imaging (MRI) poses potential safety concerns for patients with an implanted cardiac device (cardiac pacemaker or implantable cardioverter–defibrillator [ICD]). These concerns are a consequence of the potential for magnetic field–induced cardiac lead heating, which could result in myocardial thermal injury and detrimental changes in pacing properties. 1 – 3 As a result, it has long been recommended that patients with an implanted cardiac device not undergo MRI scanning, even when it otherwise may be considered to be the most appropriate diagnostic imaging method for the patient’s clinical care. 4 Over the past two decades, cardiac devices have been . . .