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An eight-year prospective controlled study about the safety and diagnostic value of cardiac and non-cardiac 1.5-T MRI in patients with a conventional pacemaker or a conventional implantable cardioverter defibrillator

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.

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Acknowledgements

This paper is dedicated to the memory of Dr. Irene Floriani, from the Mario Negri Institute, Milan, Italy, with whom the study design was initially conceived.

Funding

This study was supported by local research funds of the IRCCS Policlinico San Donato, a Clinical Research Hospital partially funded by the Italian Ministry of Health.

Author information

Correspondence to Francesco Sardanelli.

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Guarantor

The scientific guarantor of this publication is Prof. Francesco Sardanelli.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Two of the authors have significant statistical expertise.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

Prospective controlled study, performed at one institution.

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Lupo, P., Cappato, R., Di Leo, G. et al. An eight-year prospective controlled study about the safety and diagnostic value of cardiac and non-cardiac 1.5-T MRI in patients with a conventional pacemaker or a conventional implantable cardioverter defibrillator. Eur Radiol 28, 2406–2416 (2018). https://doi.org/10.1007/s00330-017-5098-z

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Keywords

  • Conventional pacemakers
  • Conventional implantable cardioverter defibrillators
  • Magnetic resonance imaging
  • Image artefacts
  • Risk-benefit ratio