Magnetic resonance imaging safety in pacemaker and implantable cardioverter defibrillator patients: how far have we come?

Eur Heart J. 2015 Jun 21;36(24):1505-11. doi: 10.1093/eurheartj/ehv086. Epub 2015 Mar 21.

Abstract

Magnetic resonance imaging (MRI) has long been regarded a general contraindication in patients with cardiovascular implanted electronic devices such as cardiac pacemakers or cardioverter defibrillators (ICDs) due to the risk of severe complications and even deaths caused by interactions of the magnetic resonance (MR) surrounding and the electric devices. Over the last decade, a better understanding of the underlying mechanisms responsible for such potentially life-threatening complications as well as technical advances have allowed an increasing number of pacemaker and ICD patients to safely undergo MRI. This review lists the key findings from basic research and clinical trials over the last 20 years, and discusses the impact on current day clinical practice. With 'MR-conditional' devices being the new standard of care, MRI in pacemaker and ICD patients has been adopted to clinical routine today. However, specific precautions and specifications of these devices should be carefully followed if possible, to avoid patient risks which might appear with new MR technology and further increasing indications and patient numbers.

Keywords: Cardiac pacemaker; Cardiovascular magnetic resonance imaging; ICD; Implantable cardioverter defibrillator; MRI conditional devices; MRI safety.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Clinical Trials as Topic
  • Contraindications
  • Defibrillators, Implantable*
  • Electromagnetic Fields
  • Hot Temperature
  • Humans
  • Magnetic Resonance Angiography*
  • Pacemaker, Artificial*
  • Patient Safety
  • Prosthesis Design
  • Risk Factors