Provision of MR imaging for patients with cardiac implantable electronic devices (CIEDs): a single-center experience and national survey.

BACKGROUND: Patients with cardiac implantable electronic devices (CIEDs) were traditionally denied access to MR imaging due to safety concerns. AIMS: The aim of this study was to review a single-center experience of MR imaging at 1.5T of patients with CIEDs and survey national availability of this service.
METHODS: Three hundred thirty-four patients with CIEDs were included in the review. Two hundred nine patients did not progress to MRI due to non MR-conditional CIEDs, retained pacing leads, recent implant insertion, and other patient factors. A record was made of CIED type, number of body parts imaged, numbers of repeat studies and complications. All devices were scanned with cardiology involvement.
RESULTS: One hundred twenty-five patients, 90 males, 35 females, aged 20-91 years progressed to MR imaging. Eighty-six patients had pacemakers, 15 had implantable cardioverter devices (ICDs), and 24 had implantable loop recorders (ILRs). Twenty-one patients had more than one body part scanned. Regions scanned included spine n = 82, joints n = 42, head n = 40, heart n = 8, and abdomen/pelvis n = 13. Twenty-six patients had multiple separate MR studies (range 2-6). Three complications included diaphragmatic stimulation when the device was switched to MR-conditional mode resulting in scan abandonment, device failure post-MRI requiring manufacturer reprogramming, and patient dizziness post reprogramming requiring cardiology review. One cardiac study was non-diagnostic due to artifact from a low left-sided ICD. Imaging of patients with pacemakers is available in 14 of 42 (38%) hospitals with MR units nationally.
CONCLUSION: MR-conditional CIEDs can be safely scanned with diagnostic quality at 1.5T using a protocol involving radiology and cardiology.