• European radiology · Jun 2018

    Controlled Clinical Trial

    An eight-year prospective controlled study about the safety and diagnostic value of cardiac and non-cardiac 1.5-T MRI in patients with a conventional pacemaker or a conventional implantable cardioverter defibrillator.

    • Pierpaolo Lupo, Riccardo Cappato, Giovanni Di Leo, Francesco Secchi, Giacomo D E Papini, Sara Foresti, Hussam Ali, Guido M G De Ambroggi, Antonio Sorgente, Gianluca Epicoco, Paola M Cannaò, and Francesco Sardanelli.
    • Arrhythmia and Electrophysiology Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
    • Eur Radiol. 2018 Jun 1; 28 (6): 2406-2416.

    ObjectivesTo investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD).MethodsWe prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted <6 weeks before enrolment or prior to 01/01/2000, with cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG).Results142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71). In the RG 98 measurements were performed in 95 patients with cPM (n=40) or cICD (n=58). No adverse events were observed. No MRI prolonged/interrupted. All cPM/cICD were correctly reprogrammed after MRI without malfunctions. One temporary communication failure was observed in one cPM-carrier. Immediately after MRI, 12/14 device interrogation parameters did not change significantly (clinically negligible changes of battery voltage and cICD charging time), without significant variations for SG versus RG. Three-12 months after MRI, 9/11 device interrogation parameters did not change significantly (clinically negligible changes of battery impedance/voltage). Non-significant changes of three markers of myocardial necrosis. Non-cardiac MRI: 82/87 diagnostic without artefacts; 4/87 diagnostic with artefacts; 1/87 partially diagnostic. Cardiac MRI: in cPM-carriers, 14/15 diagnostic with artefacts, 1/15 partially diagnostic; in cICD-carriers, 9/40 diagnostic with artefacts, 22 partially diagnostic, nine non-diagnostic.ConclusionsA favourable risk-benefit ratio of 1.5-T MRI in cPM/cICD carriers was reported.Key Points• Cooperation between radiologists and cardiac electrophysiologists allowed safe 1.5-T MRI in cPM/cICD-carriers. • No adverse events for 142 MRI in 71 cPM-carriers and 71 cICD-carriers. • Ninety-nine per cent (86/87) of non-cardiac MRI in cPM/cICD-carriers were diagnostic. • All cPM-carrier cardiac MRIs had artefacts, 14 examinations diagnostic, 1 partially diagnostic. • Twenty-three per cent (9/40) of cardiac MRI in cICD-carriers were non-diagnostic.

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