Huma Samar1, June A Yamrozik2, Ronald B Williams2, Mark Doyle2, Moneal Shah3, Christopher A Bonnet4, Robert W W Biederman5. 1. Division of Cardiology, Centre for Cardiac MRI, Allegheny General Hospital, Pittsburgh, Pennsylvania; Loma Linda Veterans Affairs Hospital, Loma Linda, California. 2. Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania. 3. Division of Cardiology, Centre for Cardiac MRI, Allegheny General Hospital, Pittsburgh, Pennsylvania; Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania. 4. Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania; Division of Electrophysiology, Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania. 5. Division of Cardiology, Centre for Cardiac MRI, Allegheny General Hospital, Pittsburgh, Pennsylvania; Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania. Electronic address: Rbiederm@wpahs.org.
Abstract
OBJECTIVES: The objective of this study was to assess the diagnostic usefulness of thoracic and nonthoracic magnetic resonance imaging (MRI) imaging in patients with implantable cardiac devices (permanent pacemaker or implantable cardioverter-defibrillators [ICDs]) to determine if there was a substantial benefit to patients with regard to diagnosis and/or management. BACKGROUND: MRI is infrequently performed on patients with conventional pacemakers or ICDs. Multiple studies have documented the safety of MRI scans in patients with implanted devices, yet the diagnostic value of this approach has not been established. METHODS: Evaluation data were acquired in 136 patients with implanted cardiac devices who underwent MRIs during a 10-year period at a single institution. Specific criteria were followed for all patients to objectively define if the diagnosis by MRI enhanced patient care; 4 questions were answered after scan interpretation by both MRI technologists and MRI physicians who performed the scan. 1) Did the primary diagnosis change? 2) Did the MRI provide additional information to the existing diagnosis? 3) Was the pre-MRI (tentative) diagnosis confirmed? 4) Did patient management change? If "Yes" was answered to any of the preceding questions, the MRI scan was considered to be of value to patient diagnosis and/or therapy. RESULTS: In 97% (n = 132) of patients, MR added value to patient diagnosis and management. In 49% (n = 67) of patients, MRI added additional valuable information to the primary diagnosis, and in 30% (n = 41) of patients, MRI changed the principle diagnosis and subsequent management of the patient. No safety issues were encountered, and no adverse effects of undergoing the MRI scan were noted in any patient. CONCLUSIONS: MRI in patients with implanted pacemakers and defibrillators added value to patient diagnosis and management, which justified the risk of the procedure. Published by Elsevier Inc.
OBJECTIVES: The objective of this study was to assess the diagnostic usefulness of thoracic and nonthoracic magnetic resonance imaging (MRI) imaging in patients with implantable cardiac devices (permanent pacemaker or implantable cardioverter-defibrillators [ICDs]) to determine if there was a substantial benefit to patients with regard to diagnosis and/or management. BACKGROUND: MRI is infrequently performed on patients with conventional pacemakers or ICDs. Multiple studies have documented the safety of MRI scans in patients with implanted devices, yet the diagnostic value of this approach has not been established. METHODS: Evaluation data were acquired in 136 patients with implanted cardiac devices who underwent MRIs during a 10-year period at a single institution. Specific criteria were followed for all patients to objectively define if the diagnosis by MRI enhanced patient care; 4 questions were answered after scan interpretation by both MRI technologists and MRI physicians who performed the scan. 1) Did the primary diagnosis change? 2) Did the MRI provide additional information to the existing diagnosis? 3) Was the pre-MRI (tentative) diagnosis confirmed? 4) Did patient management change? If "Yes" was answered to any of the preceding questions, the MRI scan was considered to be of value to patient diagnosis and/or therapy. RESULTS: In 97% (n = 132) of patients, MR added value to patient diagnosis and management. In 49% (n = 67) of patients, MRI added additional valuable information to the primary diagnosis, and in 30% (n = 41) of patients, MRI changed the principle diagnosis and subsequent management of the patient. No safety issues were encountered, and no adverse effects of undergoing the MRI scan were noted in any patient. CONCLUSIONS: MRI in patients with implanted pacemakers and defibrillators added value to patient diagnosis and management, which justified the risk of the procedure. Published by Elsevier Inc.
Entities:
Keywords:
ICD; magnetic resonance imaging; pacemakers
Authors: Constantin Gatterer; Marie-Elisabeth Stelzmüller; Andreas Kammerlander; Andreas Zuckermann; Martin Krššák; Christian Loewe; Dietrich Beitzke Journal: J Cardiovasc Magn Reson Date: 2021-03-15 Impact factor: 5.364