Abstract
Pacemakers and implantable cardiac defibrillators, together usually considered as “cardiac implantable electronic devices” (CIEDs), have been traditionally considered contraindications for cardiac magnetic resonance (CMR). Nevertheless it is estimated that 50–75% of patients with CIEDs will develop an indication for CMR due to comorbidities during their lifetime after device implantation, and, in specific cases, CMR is essential for their appropriate management. The CMR system has three major components that may affect an implanted device: (1) the main static magnetic field, (2) gradient fields, and (3) radiofrequencies. All the three components have the potential to interact with the device altering its normal function. In addition to safety issues, PMs and ICDs are responsible for significant distortion of the magnetic field homogeneity and thus artefacts that may affect the image quality. The aim of this chapter is to review the potential interactions of implanted devices in the CMR scan as well as US and European guidelines on the topic.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Levine GN, Gomes AS, Arai AE, Bluemke DA, Flamm SD, Kanal E, Manning WJ, Martin ET, Smith JM, Wilke N, Shellock FS, American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Radiology and Intervention. Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council. Circulation. 2007;116(24):2878–91.
Jung W, Jäckle S, Zvereva V. MRI and implantable cardiac electronic devices. Curr Opin Cardiol. 2015;30(1):65–73.
Yee R, Verma A, Beardsall M, Fraser J, Philippon F, Exner DV. Canadian Cardiovascular Society/Canadian Heart Rhythm Society joint position statement on the use of remote monitoring for cardiovascular implantable electronic device follow-up. Can J Cardiol. 2013;29(6):644–51.
Lowe MD, Plummer CJ, Manisty CH, Linker NJ, British Heart Rhythm Society. Safe use of MRI in people with cardiac implantable electronic devices. Heart. 2015;101(24):1950–3.
Nordbeck P, Ertl G, Ritter O. Magnetic resonance imaging safety in pacemaker and implantable cardioverter defibrillator patients: how far have we come? Eur Heart J. 2015;36(24):1505–11.
Miller JD, Nazarian S, Halperin HR. Implantable electronic cardiac devices and compatibility with magnetic resonance imaging. J Am Coll Cardiol. 2016;68(14):1590–8.
Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, Cleland J, Deharo JC, Delgado V, Elliott PM, Gorenek B, Israel CW, Leclercq C, Linde C, Mont L, Padeletti L, Sutton R, Vardas PE, ESC Committee for Practice Guidelines (CPG), Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Document Reviewers, Kirchhof P, Blomstrom-Lundqvist C, Badano LP, Aliyev F, Bänsch D, Baumgartner H, Bsata W, Buser P, Charron P, Daubert JC, Dobreanu D, Faerestrand S, Hasdai D, Hoes AW, Le Heuzey JY, Mavrakis H, McDonagh T, Merino JL, Nawar MM, Nielsen JC, Pieske B, Poposka L, Ruschitzka F, Tendera M, Van Gelder IC, Wilson CM. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J. 2013;34(29):2281–329.
Zikria JF, Machnicki S, Rhim E, Bhatti T, Graham RE. MRI of patients with cardiac pacemakers: a review of the medical literature. AJR Am J Roentgenol. 2011;196(2):390–401.
Nazarian S, Hansford R, Roguin A, Goldsher D, Zviman MM, Lardo AC, Caffo BS, Frick KD, Kraut MA, Kamel IR, Calkins H, Berger RD, Bluemke DA, Halperin HR. A prospective evaluation of a protocol for magnetic resonance imaging of patients with implanted cardiac devices. Ann Intern Med. 2011;155(7):415–24.
Russo RJ. Determining the risks of clinically indicated nonthoracic magnetic resonance imaging at 1.5 T for patients with pacemakers and implantable cardioverter-defibrillators: rationale and design of the MagnaSafe Registry. Am Heart J. 2013;165(3):266–72.
Russo RJ, Costa HS, Silva PD, Anderson JL, Arshad A, Biederman RW, Boyle NG, Frabizzio JV, Birgersdotter-Green U, Higgins SL, Lampert R, Machado CE, Martin ET, Rivard AL, Rubenstein JC, Schaerf RH, Schwartz JD, Shah DJ, Tomassoni GF, Tominaga GT, Tonkin AE, Uretsky S, Wolff SD. Assessing the risks associated with MRI in patients with a pacemaker or defibrillator. N Engl J Med. 2017;376(8):755–64.
Sasaki T, Hansford R, Zviman MM, Kolandaivelu A, Bluemke DA, Berger RD, Calkins H, Halperin HR, Nazarian S. Quantitative assessment of artifacts on cardiac magnetic resonance imaging of patients with pacemakers and implantable cardioverter-defibrillators. Circ Cardiovasc Imaging. 2011;4(6):662–70.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Imazio, M., Andriani, M., Lobetti Bodoni, L., Gaita, F. (2019). CMR and Devices. In: Learning Cardiac Magnetic Resonance . Springer, Cham. https://doi.org/10.1007/978-3-030-11608-8_13
Download citation
DOI: https://doi.org/10.1007/978-3-030-11608-8_13
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-11607-1
Online ISBN: 978-3-030-11608-8
eBook Packages: MedicineMedicine (R0)