Magnetic resonance imaging in patients with cardiac implantable electronic devices - PubMed (original) (raw)

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Magnetic resonance imaging in patients with cardiac implantable electronic devices

A H Maass et al. Neth Heart J. 2018 Dec.

Abstract

In recent years the prevalence of implantation of a cardiac implantable electronic device (CIED) has increased due to expanding implantation indications and prolonged life expectancy. Diagnostic strategies increasingly employ magnetic resonance imaging (MRI) to aid therapeutic strategies. In earlier guidelines, MRI was contra-indicated in patients with CIEDs, mainly due to previous reports of severe complications. With the development of MRI-conditional CIEDs and recent evidence concerning non-MRI-conditional CIEDs, MRIs in CIED patients can be safely performed in many hospitals.However, there are several questions that need to be addressed. Which patients can we scan? How can the scans be performed safely? And last but not least, can cardiac MRI provide diagnostic yield in patients with CIEDs?Current European guidelines are rather outdated and vague about patient selection and practical issues. There are national guidelines on this topic but several issues need extra attention and those are addressed in this point of view. It is important to create an environment with proper patient selection without unnecessary MRI scans in CIED patients, but also without unnecessary fear of complications, preventing access to MRI in patients who can benefit from this powerful diagnostic tool.

Keywords: ICD; MRI; Pacemaker; Safety.

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Conflict of interest statement

A.H. Maass received lecture fees from Medtronic and LivaNova. M.E.W. Hemels received lecture fees from Biotronik and LivaNova. C.P. Allaart received research grants from Boston Scientific and Abbott and lecture fees from Biotronik.

Figures

Fig. 1

Fig. 1

Flow diagram of patient selection and device programming for magnetic resonance imaging. MRI magnetic resonance imaging, HR heart rate, PM pacemaker, ICD implantable cardioverter defibrillator, CS coronary sinus, ECG electrocardiogram

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