Incidence and predictors of MRI scan utilization in MRI-conditional pacemaker recipients: A multicenter experience

Area of Science:

• Cardiology
• Medical Devices
• Radiology

Background:

• Magnetic resonance imaging (MRI)-conditional pacemakers (MRC) are designed to allow patients to undergo MRI scans.
• Factors such as device cost and vendor contracts may limit the widespread adoption of MRC devices.
• This study investigates the real-world utilization of MRI scans in patients with MRCs.

Purpose of the Study:

• To determine the incidence of MRI scans in patients with MRCs.
• To identify predictors of MRI scan utilization in MRC recipients.
• To project the lifetime likelihood of MRI scans in patients with MRCs.

Main Methods:

• A retrospective analysis of patients who received either an MRC or a non-MRI-conditional pacemaker (NMRC) at four medical centers.
• Data on MRI scan incidence were collected from hospital records and patient phone calls.
• Survival analysis (Weibull model) and multivariate regression were used to identify predictors and project future utilization.

Main Results:

• Of 927 MRC recipients, only 6.5% underwent an MRI during a mean follow-up of 21 months.
• MRC recipients had a higher prevalence of conditions necessitating MRI scans at baseline.
• A history of prior MRI (OR 4.5) and active smoking (OR 2.65) were independent predictors of undergoing an MRI scan post-implant.

Conclusions:

• MRI scan utilization in MRC recipients is currently low but projected to increase over the devices' lifetime.
• A history of prior MRI and active smoking are key predictors for future MRI use in this population.
• Strategies to improve MRC utilization may need to address patient selection and access to MRI services.