Author + information
- Vaughn Eyvazian,
- Duc H. Do,
- Aileen Joy Bayoneta,
- J. Finn and
- Noel Boyle
Background: Studies have shown relative safety of magnetic resonance imaging (MRI) in patients with non MRI-conditional cardiac implantable electronic devices (CIED), but few cardiac MRIs (CMR) were performed. We evaluated the safety and interpretability of CMR in these patients.
Methods: All adult patients with non MRI-conditional CIED undergoing CMR at our center from 1/2014 to 8/2016 were included. Devices were interrogated pre-CMR, reprogrammed to asynchronous pacing modes in dependent patients and off in others, and had tachytherapies disabled. Continuous telemetry, oximetry, blood pressure monitoring, and verbal contact was maintained during the study. Post-CMR, devices were reinterrogated and reprogrammed to original settings. We evaluated for adverse events and device parameter changes post-CMR and at 6 month follow up.
Results: Ninety patients with 10 pacemakers, 57 implantable cardioverter defibrillators, 23 biventricular-defibrillators were scanned with 67 right atrial (RA), 90 right ventricular (RV), and 23 left ventricular (LV) leads. Indications for CMR were assessment of scar for ventricular tachycardia ablation in 66(73%), atrial fibrillation ablation 5(6%), cardiac function 15(17%) and viability 4(4%). Two adverse events were noted: one patient had ventricular tachycardia prior to imaging and one developed chest pain that resolved after discontinuing MRI. No deaths or device failures occurred. RA and RV lead impedances were significantly reduced post-CMR (-11.3 Ω [95% CI −18.1 Ω, −4.5 Ω]), (-8.8 Ω [95% CI −14.2 Ω, −3.5 Ω]) respectively, but not at 6 months. HV and LV impedances, all amplitudes, capture thresholds, and battery status did not change significantly. By 6 months one RA and RV lead each failed requiring replacement; both followed catheter ablation in the same chamber. Using a wideband scanning protocol, 9(10%) studies were partially limited and 2(2%) severely limited by device artifact.
Conclusions: Performing CMR in CIED patients is safe; artifact-free images were obtained in the majority (88%). RA and RV lead impedances were decreased post-MRI, but did not result in clinically significant lead malfunction at 6 month follow-up.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Devices 3
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1188-075
- 2017 American College of Cardiology Foundation