Author + information
- Wilson King,
- Jason Garnreiter,
- Thomas Pilcher,
- Susan Etheridge,
- Patricia Whitaker and
- Elizabeth Saarel
MRI has historically been contraindicated in patients with cardiac pacemakers (PM) due to concerns for circuitry malfunction, rapid pacing, and heating of both the generator and leads. This is a problem given the increasing number of children and adults with PM and the growing number of indications for MRI in cardiac and noncardiac disease. We previously reported that MRI can be performed in patients with a PM and non PM-dependent rhythm with no acute adverse events and no acute change in PM function when the device is temporarily deactivated and patients are carefully monitored. In this study, we evaluated the long-term safety of MRI in pediatric patients with PM, including those with epicardial leads. Pacing thresholds, sensing thresholds, and lead impedance obtained prior to MRI were compared to subsequent PM interrogations and to controls without MRI exposure.
All patients with PM were entered into a prospective registry at a single pediatric center. Nine patients who had a non-PM dependent rhythm (mean age 13.4±8.7 years) underwent MRI with a 1.5 ? GE scanner between 6/2007 and 12/2010 (4 cardiac, 3 brain, 2 spine). Six had congenital heart disease and 3 had primary arrhythmias. Five patients had epicardial leads. PM included dual chamber (2), atrial (3), and ventricular (4) systems.
No adverse reactions occurred during or immediately after the MRI, and PM settings and function were unchanged immediately after the scan. Patients were followed for a mean of 3.2 years after MRI. No PM failed during the interim. Atrial and ventricular lead sensing, pacing, and impedance did not significantly change, and were not significantly different when compared to controls. Subgroup analysis did not detect any significant pacing, sensing, or impedance changes for patients with either endocardial or epicardial leads.
MRI did not change long-term PM generator function, sensing or pacing thresholds, or lead impedance in our pediatric patients. More data is required to determine the long-term safety of MRI in children with PM including those with epicardial leads.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Cardiology Solutions: Congenital Imaging
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1160-120
- 2013 American College of Cardiology Foundation