[MRI in patients with a pacemaker or ICD requires expertise]

Area of Science:

• Cardiovascular Imaging
• Medical Device Safety
• Radiology

Background:

• Cardiac devices not designated as MRI-conditional pose potential risks during MRI scans.
• Previous research on MRI safety in patients with legacy cardiac devices is limited.
• Ensuring patient safety during MRI is critical, especially with implanted cardiac technology.

Purpose of the Study:

• To evaluate the safety of magnetic resonance imaging (MRI) in patients with legacy cardiac devices.
• To assess the incidence of adverse events in patients undergoing MRI with non-MRI-conditional cardiac devices.
• To determine the necessity of specialized protocols and expert teams for these procedures.

Main Methods:

• A large cohort study involving over 2100 thoracic and nonthoracic MRI examinations.
• Inclusion of 1509 patients with legacy cardiac devices.
• Implementation of a prespecified safety protocol during MRI procedures.

Main Results:

• No long-term, clinically significant adverse events were observed in the study cohort.
• Interactions between MRI and legacy cardiac devices occurred but were not life-threatening.
• Clinical consequences of these interactions remain unpredictable.

Conclusions:

• While MRI may be considered relatively safe with precautions, the study questions a blanket "safe" designation for legacy devices.
• Performance of MRI in patients with legacy devices should be restricted to centers of excellence.
• A multidisciplinary team of radiological and cardiac experts is essential for managing risks.