Claas Philip Naehle MD, Presenter: Research grant, Medtronic, Inc

Jens Kreuz, Abstract Co-Author: Nothing to Disclose

Jörg-Otto Schwab, Abstract Co-Author: Consultant, Medtronic, Inc Consultant, St. Jude Medical, Inc

Roger Luechinger PhD, Abstract Co-Author: Research Consultant, Medtronic, Inc

Hans H. Schild MD, Abstract Co-Author: Nothing to Disclose

Daniel K.H. Thomas MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to investigate safety, feasibility and diagnostic value of MRI in cardiac applications (CMR) in patients PMs and ICDs for the first time.  

32 PM/ICD patients with a clinical need for CMR were examined. The specific absorption rate (SAR) was limited to 1.5 W/kg. Devices were reprogrammed pre-CMR to minimize interference with the electromagnetic fields. Devices were interrogated pre- and post-CMR and after 3 months. Troponin I levels were measured pre- and post-CMR, image qualtity (IQ) and diagnostic value (DV) of CMR were assessed.

All devices could be reprogrammed normally post-CMR. No significant changes of PCT, lead impedance, and troponin I were observed. IQ in patients with right-sided devices (RSD) was better compared to patients with left-sided devices (LSD) (p<0.05), and less myocardial segments were affected by device-related artefacts (p<0.05). DV was rated as sufficiently high, allowing for diagnosis, or better in 12/12 (100%) patients with RSD, and only in 7/20 (35%) patients with LSD.

CMR may be performed safely when limiting SAR, appropriately monitoring patients and following device reprogramming. CMR delivers good IQ and DV in patients with RSD. CMR in patients with RSD may therefore be performed with an acceptable risk/benefit ratio, while the risk/benefit ratio is rather unfavorable in patients with LSD.

CMR may safely be performed in selected patients with PMs/ICDs, however severe device-related artifacts may limit the clinical value of CMR in patients with left-sided devices.

Naehle, C, Kreuz, J, Schwab, J, Luechinger, R, Schild, H, Thomas, D, Safety, Feasibility, and Diagnostic Value of Cardiac Magnetic Resonance Imaging in Patients with Cardiac Pacemakers and Implantable Cardioverters/Defibrillators at 1.5 Tesla.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012630.html