BEGOÑA IGUAL MUÑOZ MD, Abstract Co-Author: Nothing to Disclose

Maria jose Sancho-Tello De carranza MD, Abstract Co-Author: Nothing to Disclose

Francisco Fuentes Buendia, Abstract Co-Author: Nothing to Disclose

Fernando Más-Estellés MD, Abstract Co-Author: Nothing to Disclose

Oscar Cano Perez, Abstract Co-Author: Nothing to Disclose

Almudena Lucas-Perez MD, Presenter: Nothing to Disclose

Pablo Nogues-Melendez MD, Abstract Co-Author: Nothing to Disclose

Alicia Maceira MD,PhD, Abstract Co-Author: Nothing to Disclose

Jordi Estornell MD,PhD, Abstract Co-Author: Nothing to Disclose

Recent studies suggest that cardiovascular magnetic resonance (CMR) could be carried out in  patients with antiarrhythmic devices (AAD), such as pacemakers (PM) or implantable cardioverter-defibrillators (ICD) but CMR can be technically demanding and the signal loss  induced by the AAD may limit the diagnostic yield of this  technique. The aim of this study was 1) to assess the safety and diagnostic usefulness of CMR in patients with AAD, 2) to analyse which factors may affect image quality in these scans.

42 patients with AAD referred for a CMR scan were included and clinically assessed before and after the scan. The following parameters were analysed: 1. type of AAD (ICD, PM) 2.weight and volume of AAD 3. Reason for CMR referral (myocardial perfusion/viability study-MPV, right ventricular function quantification study - RVF), 4. Area of signal loss around the AAD (SLA) analysed in basal slice of cardiac short axis in steady-state free-precession sequences  (TRUE FISP) by a ROI whose center is located in the center of AAD and includes any SLA. 5. The need to change the usual CMR acquisition protocol. (TRUE FISP change to Turbo fast low angle shot sequences). CMR was considered nonconclusive when it failed to solve the clinical questions raised for each individual patient.

Seven patients had an ICD implanted and another 35 a PM, being 11 of them PM dependant. Neither clinical events nor patient complaints were reported. No significant changes were seen in AAD function after the scan with respect to thresholds, battery charge, sensing signal amplitude and impedance. In 24 cases (56%) a change in CMR acquisition protocol was required. SLA was correlated with AAD weight (r=0, 7 p<0,01) and volume (r=0.7 p<0, 01). CMR was non conclusive in  8 patients (19%), and this happened mainly in patients with ICD (57% vs. 12% with PM, p= 0, 02), in MPV (43% vs. 5% in RVF, p=0, 05) and in AAD of high volume (23+13mL vs. 14+ 7mL, p=0, 04).  

1. CMR can be safely done in AAD patients with good diagnostic yield. 2. SLA correlates with AAD weight and volume. 3. MPV CMR scans in patients with high volume AAD should not be advised.

CMR can be safely done in AAD patients with good diagnostic yield. MPV CMR scans in patients with high volume AAD should not be advised due to high incidence of inconclusive tests.

MUÑOZ, B, De carranza, M, Buendia, F, Más-Estellés, F, Perez, O, Lucas-Perez, A, Nogues-Melendez, P, Maceira, A, Estornell, J, Cardiac Magnetic Resonance in Patients with Antiarrhythmic Devices: Safety and Image Quality Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11001387.html