Magnetic Resonance Imaging and Cardiac Devices: How Safe Is Safe Enough?
Authors: Matthew R. Reynolds, Peter Zimetbaum
Journal: Annals of Internal Medicine (2011)

Editorials4 October 2011Magnetic Resonance Imaging and Cardiac Devices: How Safe Is Safe Enough?Matthew R. Reynolds, MD, MSc and Peter Zimetbaum, MDMatthew R. Reynolds, MD, MScFrom Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215. and Peter Zimetbaum, MDFrom Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-7-201110040-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Several million persons in the United States are currently living with implanted cardiac rhythm management devices (CRMDs); a few hundred thousand new devices are implanted annually (1). The majority of these patients are older than 60 years. As the long-term survival of this population improves and utilization of CRMDs continues to grow (2), the probability increases that many of these patients will encounter medical situations for which magnetic resonance imaging (MRI) may be useful, or even critical, for optimal diagnosis and treatment. This likelihood is difficult to assess because the value of MRI relative to alternatives may vary, but estimates ...References1. Hammill SC, Kremers MS, Stevenson LW, Heidenreich PA, Lang CM, Curtis JP, et al. Review of the registry's fourth year, incorporating lead data and pediatric ICD procedures, and use as a national performance measure. Heart Rhythm. 2010;7:1340-5. [PMID: 20647056] CrossrefMedlineGoogle Scholar2. Hauser RG. The growing mismatch between patient longevity and the service life of implantable cardioverter-defibrillators. J Am Coll Cardiol. 2005;45:2022-5. [PMID: 15963404] CrossrefMedlineGoogle Scholar3. Kalin R, Stanton MS. Current clinical issues for MRI scanning of pacemaker and defibrillator patients. Pacing Clin Electrophysiol. 2005;28:326-8. [PMID: 15826268] CrossrefMedlineGoogle Scholar4. Fontaine JM, Mohamed FB, Gottlieb C, Callans DJ, Marchlinski FE. Rapid ventricular pacing in a pacemaker patient undergoing magnetic resonance imaging. Pacing Clin Electrophysiol. 1998;21:1336-9. [PMID: 9633085] CrossrefMedlineGoogle Scholar5. Anfinsen OG, Berntsen RF, Aass H, Kongsgaard E, Amlie JP. Implantable cardioverter defibrillator dysfunction during and after magnetic resonance imaging. Pacing Clin Electrophysiol. 2002;25:1400-2. [PMID: 12380781] CrossrefMedlineGoogle Scholar6. Wilkoff BL, Bello D, Taborsky M, Vymazal J, Kanal E, Heuer H, et al; EnRhythm MRI SureScan Pacing System Study Investigators. Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environment. Heart Rhythm. 2011;8:65-73. [PMID: 20933098] CrossrefMedlineGoogle Scholar7. 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Strategy for safe performance of extrathoracic magnetic resonance imaging at 1.5 tesla in the presence of cardiac pacemakers in non-pacemaker-dependent patients: a prospective study with 115 examinations. Circulation. 2006;114:1285-92. [PMID: 16966587] CrossrefMedlineGoogle Scholar11. Mollerus M, Albin G, Lipinski M, Lucca J. Magnetic resonance imaging of pacemakers and implantable cardioverter-defibrillators without specific absorption rate restrictions. Europace. 2010;12:947-51. [PMID: 20353963] CrossrefMedlineGoogle Scholar12. Strach K, Naehle CP, Mühlsteffen A, Hinz M, Bernstein A, Thomas D, et al. Low-field magnetic resonance imaging: increased safety for pacemaker patients? Europace. 2010;12:952-60. [PMID: 20356915] CrossrefMedlineGoogle Scholar13. Nazarian S, Hansford R, Roguin A, Goldsher D, Zviman MM, Lardo AC, et al. A prospective evaluation of a protocol for magnetic resonance imaging of patients with implanted cardiac devices. Ann Intern Med. 2011;155:415-24. LinkGoogle Scholar14. Luechinger R, Zeijlemaker VA, Pedersen EM, Mortensen P, Falk E, Duru F, et al. In vivo heating of pacemaker leads during magnetic resonance imaging. Eur Heart J. 2005;26:376-83. [PMID: 15618060] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2029.Corresponding Author: Peter Zimetbaum, MD, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Boston, MA 02215.Current Author Addresses: Drs. Reynolds and Zimetbaum: Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Boston, MA 02215. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Prospective Evaluation of a Protocol for Magnetic Resonance Imaging of Patients With Implanted Cardiac Devices Saman Nazarian , Rozann Hansford , Ariel Roguin , Dorith Goldsher , Menekhem M. Zviman , Albert C. Lardo , Brian S. Caffo , Kevin D. Frick , Michael A. Kraut , Ihab R. Kamel , Hugh Calkins , Ronald D. Berger , David A. Bluemke , and Henry R. Halperin Metrics Cited byCardiac Magnetic Resonance in Patients With Cardiac Implantable Electronic DevicesMRI Conditional Devices, Safety, and Access: Choose Wisely and When You Come to the Fork in the Road, Take ItCardiovascular magnetic resonance with an MR compatible pacemakerRandomized trial of pacemaker and lead system for safe scanning at 1.5 TeslaImplantable Devices and Magnetic Resonance Imaging 4 October 2011Volume 155, Issue 7Page: 470-472KeywordsDiagnostic imagingElectrophysiological techniquesHeartHeart rateMagnetic resonance imagingRisk managementSafetyTachycardia ePublished: 4 October 2011 Issue Published: 4 October 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...