Magnetic resonance imaging in patients with implantable cardiac devices

The use of magnetic resonance imaging (MRI) in patients with implantable cardiac devices, such as pacemakers, cardioverter defibrillators, and loop recorders, has been contraindicated based on concerns regarding the powerful magnetic field generated by MRI. Due to the widespread application and powerful diagnostic capability of MRI, there are instances in which denying a patient with an implantable cardiac device an MRI evaluation may influence the quality of health care received. There are data to suggest that MRI might be considered a relative contraindication instead of an absolute contraindication in device patients when precautions are taken by experienced physicians to lower the risk of adverse events. Despite the potential concerns, several hundred non-pacemaker-dependent patients and several pacemaker-dependent patients have undergone MRI without complications while being monitored under a number of different safety protocols. Various strategies have been used to minimize the risk of performing MRI procedures in device patients. Patient selection must be rigorous and made on a case-by-case basis.