• Neurol Neurochir Pol · Nov 2018

    Review

    State-of-the-art approach towards magnetic resonance imaging of the nervous system structures in patients with cardiac implantable electronic devices.

    • Katarzyna Gniadek-Olejniczak, Karol Makowski, Adam Olszewski, Kazimierz Tomczykiewicz, Andrzej Krawczyk, and Józef Mróz.
    • Department of Rehabilitation with a Neurological Subunit, Military Institute of Medicine, Warsaw, Poland. Electronic address: kgniadek-olejniczak@wim.mil.pl.
    • Neurol Neurochir Pol. 2018 Nov 1; 52 (6): 652-656.

    IntroductionMRI generated forces are the source of potential complications in patients with cardiac implantable electronic devices (CIED). The technological progress, and growing clinical evidence concerning the operation of the contemporary MR non-conditional CIEDs during MRI, have started to significantly change our every-day clinical practice. Nevertheless, a lot of patients who could have an MRI performed safely, still have been refused the examination.State Of The ArtIn many clinical situations, an MRI examination in a patient with a CIED is reasonable, and is linked to a negligible risk of complications if performed under strict precautions. The MagnaSave Registry that evaluated the influence of nonthoracic MRI on the function of MR non-conditional CIEDs, and numerous studies involving thoracic and non-thoracic MRIs in patients with legacy CIEDs, have confirmed the feasibility and safety of such examinations. In this article, practical tips aimed towards improving the safety of MRI in MR conditional and non-conditional CIED patients are largely based on the very recently released (2017) HRS expert consensus statement.Clinical ImplicationsClinical data emphasize the necessity of making the MRI more accessible to CIED patients, also in the case of MR non-conditional systems or when the thorax MR imaging is clinically reasonable. This goal should be achieved by increasing the number of centers complying with respective recommendations and applying protocols that would guarantee the highest safety level.Future DirectionsFurther studies are warranted to assess safety issues related to the main current contraindication to MRI, i.e., the presence of abandoned leads.Copyright © 2018 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved.

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