How we do it: Cardiac implantable devices are not a contraindication to MRI: time for a paradigm shift

Area of Science:

• Medical Imaging
• Cardiology
• Pediatrics

Background:

• Magnetic resonance imaging (MRI) offers superior contrast resolution and no radiation, crucial for detailed tissue characterization and anatomical imaging.
• Congenital heart disease (CHD) patients often require cardiac implantable electrical devices (CIEDs), posing challenges for MRI compatibility.
• Previous MRI safety concerns for CIEDs are being re-evaluated due to technological advancements.

Purpose of the Study:

• To discuss MRI safety considerations for patients with CIEDs.
• To investigate unique challenges in pediatric populations regarding MRI and CIEDs.
• To outline methods for ensuring safe MRI access in this patient group.

Main Methods:

• Review of current literature on MRI safety in patients with CIEDs.
• Analysis of pediatric-specific issues related to MRI and CIEDs.
• Description of institutional protocols for safe MRI procedures.

Main Results:

• While MRI safety for CIEDs is improving, specific data for pediatric patients and their devices is lacking.
• Pediatric patients with CHD requiring CIEDs present unique safety considerations for MRI.
• Specialized institutional guidelines are crucial for safe MRI access.

Conclusions:

• Safe MRI access for patients with CIEDs is increasingly feasible, but pediatric applications require careful consideration.
• The lack of pediatric-specific safety data necessitates a cautious approach and robust institutional protocols.
• Developing and adhering to specialized guidelines is paramount for the safe utilization of MRI in pediatric patients with CIEDs.