Pierpaolo Lupo1,2, Riccardo Cappato1,3, Giovanni Di Leo4, Francesco Secchi4, Giacomo D E Papini4, Sara Foresti1,2, Hussam Ali1,2, Guido M G De Ambroggi1,2, Antonio Sorgente1,5, Gianluca Epicoco1,6, Paola M Cannaò4, Francesco Sardanelli7,8. 1. Arrhythmia and Electrophysiology Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. 2. Humanitas Clinical Research Institute, Arrhythmia and Electrophysiology Unit II, Rozzano, Milan, Italy. 3. Humanitas University Department of Biomedical Sciences and Humanitas Clinical Research Institute, Rozzano, Milan, Italy. 4. Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. 5. Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates. 6. ASST Ospedale di Lecco, Lecco, Italy. 7. Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. francesco.sardanelli@unimi.it. 8. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy. francesco.sardanelli@unimi.it.
Abstract
OBJECTIVES: To investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD). METHODS: We prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted <6 weeks before enrolment or prior to 01/01/2000, with cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG). RESULTS: 142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71). In the RG 98 measurements were performed in 95 patients with cPM (n=40) or cICD (n=58). No adverse events were observed. No MRI prolonged/interrupted. All cPM/cICD were correctly reprogrammed after MRI without malfunctions. One temporary communication failure was observed in one cPM-carrier. Immediately after MRI, 12/14 device interrogation parameters did not change significantly (clinically negligible changes of battery voltage and cICD charging time), without significant variations for SG versus RG. Three-12 months after MRI, 9/11 device interrogation parameters did not change significantly (clinically negligible changes of battery impedance/voltage). Non-significant changes of three markers of myocardial necrosis. Non-cardiac MRI: 82/87 diagnostic without artefacts; 4/87 diagnostic with artefacts; 1/87 partially diagnostic. Cardiac MRI: in cPM-carriers, 14/15 diagnostic with artefacts, 1/15 partially diagnostic; in cICD-carriers, 9/40 diagnostic with artefacts, 22 partially diagnostic, nine non-diagnostic. CONCLUSIONS: A favourable risk-benefit ratio of 1.5-T MRI in cPM/cICD carriers was reported. KEY POINTS: • Cooperation between radiologists and cardiac electrophysiologists allowed safe 1.5-T MRI in cPM/cICD-carriers. • No adverse events for 142 MRI in 71 cPM-carriers and 71 cICD-carriers. • Ninety-nine per cent (86/87) of non-cardiac MRI in cPM/cICD-carriers were diagnostic. • All cPM-carrier cardiac MRIs had artefacts, 14 examinations diagnostic, 1 partially diagnostic. • Twenty-three per cent (9/40) of cardiac MRI in cICD-carriers were non-diagnostic.
OBJECTIVES: To investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD). METHODS: We prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted <6 weeks before enrolment or prior to 01/01/2000, with cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG). RESULTS: 142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71). In the RG 98 measurements were performed in 95 patients with cPM (n=40) or cICD (n=58). No adverse events were observed. No MRI prolonged/interrupted. All cPM/cICD were correctly reprogrammed after MRI without malfunctions. One temporary communication failure was observed in one cPM-carrier. Immediately after MRI, 12/14 device interrogation parameters did not change significantly (clinically negligible changes of battery voltage and cICD charging time), without significant variations for SG versus RG. Three-12 months after MRI, 9/11 device interrogation parameters did not change significantly (clinically negligible changes of battery impedance/voltage). Non-significant changes of three markers of myocardial necrosis. Non-cardiac MRI: 82/87 diagnostic without artefacts; 4/87 diagnostic with artefacts; 1/87 partially diagnostic. Cardiac MRI: in cPM-carriers, 14/15 diagnostic with artefacts, 1/15 partially diagnostic; in cICD-carriers, 9/40 diagnostic with artefacts, 22 partially diagnostic, nine non-diagnostic. CONCLUSIONS: A favourable risk-benefit ratio of 1.5-T MRI in cPM/cICD carriers was reported. KEY POINTS: • Cooperation between radiologists and cardiac electrophysiologists allowed safe 1.5-T MRI in cPM/cICD-carriers. • No adverse events for 142 MRI in 71 cPM-carriers and 71 cICD-carriers. • Ninety-nine per cent (86/87) of non-cardiac MRI in cPM/cICD-carriers were diagnostic. • All cPM-carrier cardiac MRIs had artefacts, 14 examinations diagnostic, 1 partially diagnostic. • Twenty-three per cent (9/40) of cardiac MRI in cICD-carriers were non-diagnostic.
Entities:
Keywords:
Conventional implantable cardioverter defibrillators; Conventional pacemakers; Image artefacts; Magnetic resonance imaging; Risk-benefit ratio
Authors: Andrew S Phelps; David M Naeger; Jesse L Courtier; Jack W Lambert; Peter A Marcovici; Javier E Villanueva-Meyer; John D MacKenzie Journal: AJR Am J Roentgenol Date: 2015-01 Impact factor: 3.959
Authors: Claas P Naehle; Katharina Strach; Daniel Thomas; Carsten Meyer; Markus Linhart; Sascha Bitaraf; Harold Litt; Jörg Otto Schwab; Hans Schild; Torsten Sommer Journal: J Am Coll Cardiol Date: 2009-08-04 Impact factor: 24.094
Authors: Sanjay Dandamudi; Jeremy D Collins; James C Carr; Pat Mongkolwat; Amir A Rahsepar; Todd T Tomson; Nishant Verma; Rishi Arora; Alex B Chicos; Susan S Kim; Albert C Lin; Rod S Passman; Bradley P Knight Journal: Acad Radiol Date: 2016-10-04 Impact factor: 3.173
Authors: Francesca Baessato; Marco Guglielmo; Giuseppe Muscogiuri; Andrea Baggiano; Laura Fusini; Stefano Scafuri; Mario Babbaro; Rocco Mollace; Ada Collevecchio; Andrea I Guaricci; Gianluca Pontone Journal: Biomed Res Int Date: 2021-01-14 Impact factor: 3.411
Authors: Marc Dewey; Maria Siebes; Marc Kachelrieß; Klaus F Kofoed; Pál Maurovich-Horvat; Konstantin Nikolaou; Wenjia Bai; Andreas Kofler; Robert Manka; Sebastian Kozerke; Amedeo Chiribiri; Tobias Schaeffter; Florian Michallek; Frank Bengel; Stephan Nekolla; Paul Knaapen; Mark Lubberink; Roxy Senior; Meng-Xing Tang; Jan J Piek; Tim van de Hoef; Johannes Martens; Laura Schreiber Journal: Nat Rev Cardiol Date: 2020-02-24 Impact factor: 32.419