Pacemakers in MRI for the Neuroradiologist

Fellows’ Journal Club

The authors review the relevant cardiac implantable electronic devices encountered in practice today, the background physics/technical factors related to scanning these devices, the multidisciplinary screening protocol used at their institution for scanning patients with implantable cardiac devices, and their experience in safely performing these examinations since 2010.

Figure 4 from paper
Absolute contraindications: chest x-ray examinations with abandoned and epicardial leads. Posteroanterior view of the chest (A) demonstrates an abandoned lead (black arrows) in a patient with a dual-chamber pacemaker device. B, An abandoned right ventricular lead (black arrows) in a patient with a single-lead pacemaker device. The black arrowhead denotes a fracture of the abandoned lead. C, A patient with a biventricular ICD pacing system, which includes transvenous atrial and right ventricular leads and 2 permanent epicardial pacing leads (black arrows). None of these 3 patients would be cleared to undergo MR imaging examination at our institution.

SUMMARY

Cardiac implantable electronic devices are frequently encountered in clinical practice in patients being screened for MR imaging examinations. Traditionally, the presence of these devices has been considered a contraindication to undergoing MR imaging. Growing evidence suggests that most of these patients can safely undergo an MR imaging examination if certain conditions are met. This document will review the relevant cardiac implantable electronic devices encountered in practice today, the background physics/technical factors related to scanning these devices, the multidisciplinary screening protocol used at our institution for scanning patients with implantable cardiac devices, and our experience in safely performing these examinations since 2010.

Read this article: http://bit.ly/2BBe5Qc

Pacemakers in MRI for the Neuroradiologist
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jross
Jeffrey Ross • Mayo Clinic, Phoenix

Dr. Jeffrey S. Ross is a Professor of Radiology at the Mayo Clinic College of Medicine, and practices neuroradiology at the Mayo Clinic in Phoenix, Arizona. His publications include over 100 peer-reviewed articles, nearly 60 non-refereed articles, 33 book chapters, and 10 books. He was an AJNR Senior Editor from 2006-2015, is a member of the editorial board for 3 other journals, and a manuscript reviewer for 10 journals. He became Editor-in-Chief of the AJNR in July 2015. He received the Gold Medal Award from the ASSR in 2013.

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