Safety and quality of 1.5-T MRI in patients with conventional and MRI-conditional cardiac implantable electronic devices after implementation of a standardized protocol

Juan C. Camacho, Courtney Coursey Moreno, Anand D. Shah, Pardeep Kumar Mittal, Andenet Mengistu, Michael S. Lloyd, Mikhael F. El-Chami, Stamatios Lerakis, Amit M. Saindane

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to evaluate the safety and diagnostic utility of 1.5-T MRI examinations of individuals with conventional and MRI-conditional cardiac implantable electronic devices (CIEDs). SUBJECTS AND METHODS. Patients with a CIED who were referred for MRI were evaluated by radiologists and cardiac electrophysiologists for study participation. CIED interrogation was performed immediately before and after MRI, and cardiac telemetry monitoring was performed during MRI. CIED programming changes, malfunctions, and intraprocedural events were documented. Whether diagnostic questions were answered and whether artifacts related to the CIED were present and negatively affected image interpretation were recorded. RESULTS. One hundred thirteen MRI examinations were performed for 104 patients with CIEDs (74 pacemakers [60 conventional, 14 MRI conditional]; 39 implantable cardiac defibrillators). Device reprogramming was required before MRI for 62.8% of studies (71/113). No significant changes in lead parameters were noted during or after MRI. Electromagnetic noise was detected on at least one lead in 7.1% of studies. Three patients reported transient symptoms (one case each of heating at the pocket site, tingling at the pocket site, and palpitations). All images were considered diagnostic for the original clinical query. Artifacts related to CIEDs were described in 3.5% of MRI reports (4/113) and were present only when the pulse generator was included in the FOV. CIED-related artifacts limited evaluation of tissues immediately adjacent to the pulse generator. CONCLUSION. Establishment of a multidisciplinary work flow allows individuals with conventional and MRI-conditional CIEDs to safely undergo 1.5-T MRI with diagnostic questions consistently answered.

Original languageEnglish (US)
Pages (from-to)599-604
Number of pages6
JournalAmerican Journal of Roentgenology
Volume207
Issue number3
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

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Safety
Equipment and Supplies
Artifacts
Telemetry
Workflow
Implantable Defibrillators
Electromagnetic Phenomena
Heating
Noise

Keywords

  • Defibrillator
  • MRI
  • MRI safety
  • MRI-conditional pacemaker
  • Pacemaker

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Safety and quality of 1.5-T MRI in patients with conventional and MRI-conditional cardiac implantable electronic devices after implementation of a standardized protocol. / Camacho, Juan C.; Moreno, Courtney Coursey; Shah, Anand D.; Mittal, Pardeep Kumar; Mengistu, Andenet; Lloyd, Michael S.; El-Chami, Mikhael F.; Lerakis, Stamatios; Saindane, Amit M.

In: American Journal of Roentgenology, Vol. 207, No. 3, 01.09.2016, p. 599-604.

Research output: Contribution to journalArticle

Camacho, Juan C. ; Moreno, Courtney Coursey ; Shah, Anand D. ; Mittal, Pardeep Kumar ; Mengistu, Andenet ; Lloyd, Michael S. ; El-Chami, Mikhael F. ; Lerakis, Stamatios ; Saindane, Amit M. / Safety and quality of 1.5-T MRI in patients with conventional and MRI-conditional cardiac implantable electronic devices after implementation of a standardized protocol. In: American Journal of Roentgenology. 2016 ; Vol. 207, No. 3. pp. 599-604.
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abstract = "OBJECTIVE. The purpose of this study was to evaluate the safety and diagnostic utility of 1.5-T MRI examinations of individuals with conventional and MRI-conditional cardiac implantable electronic devices (CIEDs). SUBJECTS AND METHODS. Patients with a CIED who were referred for MRI were evaluated by radiologists and cardiac electrophysiologists for study participation. CIED interrogation was performed immediately before and after MRI, and cardiac telemetry monitoring was performed during MRI. CIED programming changes, malfunctions, and intraprocedural events were documented. Whether diagnostic questions were answered and whether artifacts related to the CIED were present and negatively affected image interpretation were recorded. RESULTS. One hundred thirteen MRI examinations were performed for 104 patients with CIEDs (74 pacemakers [60 conventional, 14 MRI conditional]; 39 implantable cardiac defibrillators). Device reprogramming was required before MRI for 62.8{\%} of studies (71/113). No significant changes in lead parameters were noted during or after MRI. Electromagnetic noise was detected on at least one lead in 7.1{\%} of studies. Three patients reported transient symptoms (one case each of heating at the pocket site, tingling at the pocket site, and palpitations). All images were considered diagnostic for the original clinical query. Artifacts related to CIEDs were described in 3.5{\%} of MRI reports (4/113) and were present only when the pulse generator was included in the FOV. CIED-related artifacts limited evaluation of tissues immediately adjacent to the pulse generator. CONCLUSION. Establishment of a multidisciplinary work flow allows individuals with conventional and MRI-conditional CIEDs to safely undergo 1.5-T MRI with diagnostic questions consistently answered.",
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T1 - Safety and quality of 1.5-T MRI in patients with conventional and MRI-conditional cardiac implantable electronic devices after implementation of a standardized protocol

AU - Camacho, Juan C.

AU - Moreno, Courtney Coursey

AU - Shah, Anand D.

AU - Mittal, Pardeep Kumar

AU - Mengistu, Andenet

AU - Lloyd, Michael S.

AU - El-Chami, Mikhael F.

AU - Lerakis, Stamatios

AU - Saindane, Amit M.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - OBJECTIVE. The purpose of this study was to evaluate the safety and diagnostic utility of 1.5-T MRI examinations of individuals with conventional and MRI-conditional cardiac implantable electronic devices (CIEDs). SUBJECTS AND METHODS. Patients with a CIED who were referred for MRI were evaluated by radiologists and cardiac electrophysiologists for study participation. CIED interrogation was performed immediately before and after MRI, and cardiac telemetry monitoring was performed during MRI. CIED programming changes, malfunctions, and intraprocedural events were documented. Whether diagnostic questions were answered and whether artifacts related to the CIED were present and negatively affected image interpretation were recorded. RESULTS. One hundred thirteen MRI examinations were performed for 104 patients with CIEDs (74 pacemakers [60 conventional, 14 MRI conditional]; 39 implantable cardiac defibrillators). Device reprogramming was required before MRI for 62.8% of studies (71/113). No significant changes in lead parameters were noted during or after MRI. Electromagnetic noise was detected on at least one lead in 7.1% of studies. Three patients reported transient symptoms (one case each of heating at the pocket site, tingling at the pocket site, and palpitations). All images were considered diagnostic for the original clinical query. Artifacts related to CIEDs were described in 3.5% of MRI reports (4/113) and were present only when the pulse generator was included in the FOV. CIED-related artifacts limited evaluation of tissues immediately adjacent to the pulse generator. CONCLUSION. Establishment of a multidisciplinary work flow allows individuals with conventional and MRI-conditional CIEDs to safely undergo 1.5-T MRI with diagnostic questions consistently answered.

AB - OBJECTIVE. The purpose of this study was to evaluate the safety and diagnostic utility of 1.5-T MRI examinations of individuals with conventional and MRI-conditional cardiac implantable electronic devices (CIEDs). SUBJECTS AND METHODS. Patients with a CIED who were referred for MRI were evaluated by radiologists and cardiac electrophysiologists for study participation. CIED interrogation was performed immediately before and after MRI, and cardiac telemetry monitoring was performed during MRI. CIED programming changes, malfunctions, and intraprocedural events were documented. Whether diagnostic questions were answered and whether artifacts related to the CIED were present and negatively affected image interpretation were recorded. RESULTS. One hundred thirteen MRI examinations were performed for 104 patients with CIEDs (74 pacemakers [60 conventional, 14 MRI conditional]; 39 implantable cardiac defibrillators). Device reprogramming was required before MRI for 62.8% of studies (71/113). No significant changes in lead parameters were noted during or after MRI. Electromagnetic noise was detected on at least one lead in 7.1% of studies. Three patients reported transient symptoms (one case each of heating at the pocket site, tingling at the pocket site, and palpitations). All images were considered diagnostic for the original clinical query. Artifacts related to CIEDs were described in 3.5% of MRI reports (4/113) and were present only when the pulse generator was included in the FOV. CIED-related artifacts limited evaluation of tissues immediately adjacent to the pulse generator. CONCLUSION. Establishment of a multidisciplinary work flow allows individuals with conventional and MRI-conditional CIEDs to safely undergo 1.5-T MRI with diagnostic questions consistently answered.

KW - Defibrillator

KW - MRI

KW - MRI safety

KW - MRI-conditional pacemaker

KW - Pacemaker

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