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State-of-the-art approach towards magnetic resonance imaging of the nervous system structures in patients with cardiac implantable electronic devices
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Abstract
Introduction: MRI generated forces are the source of potential complications in patients with cardiac implantable electronic devices (CIED). The technological progress, and growing clinical evidence concerning the operation of the contemporary MR non-conditional CIEDs during MRI, have started to significantly change our every-day clinical practice. Nevertheless, a lot of patients who could have an MRI performed safely, still have been refused the examination.
State-of-the-art: In many clinical situations, an MRI examination in a patient with a CIED is reasonable, and is linked to a negligible risk of complications if performed under strict precautions. The MagnaSave Registry that evaluated the influence of nonthoracic MRI on the function of MR non-conditional CIEDs, and numerous studies involving thoracic and nonthoracicMRIs in patients with legacy CIEDs, have confirmed the feasibility and safety of such examinations. In this article, practical tips aimed towards improving the safety of MRI in MR conditional and non-conditional CIED patients are largely based on the very recently released (2017) HRS expert consensus statement.
Clinical implications: Clinical data emphasize the necessity of making the MRI more accessible to CIED patients, also in the case of MR non-conditional systems or when the thorax MR imaging is clinically reasonable. This goal should be achieved by increasing the number of centers complying with respective recommendations and applying protocols that would guarantee the highest safety level.
Future directions: Further studies are warranted to assess safety issues related to the main current contraindication to MRI, i.e., the presence of abandoned leads.
Abstract
Introduction: MRI generated forces are the source of potential complications in patients with cardiac implantable electronic devices (CIED). The technological progress, and growing clinical evidence concerning the operation of the contemporary MR non-conditional CIEDs during MRI, have started to significantly change our every-day clinical practice. Nevertheless, a lot of patients who could have an MRI performed safely, still have been refused the examination.
State-of-the-art: In many clinical situations, an MRI examination in a patient with a CIED is reasonable, and is linked to a negligible risk of complications if performed under strict precautions. The MagnaSave Registry that evaluated the influence of nonthoracic MRI on the function of MR non-conditional CIEDs, and numerous studies involving thoracic and nonthoracicMRIs in patients with legacy CIEDs, have confirmed the feasibility and safety of such examinations. In this article, practical tips aimed towards improving the safety of MRI in MR conditional and non-conditional CIED patients are largely based on the very recently released (2017) HRS expert consensus statement.
Clinical implications: Clinical data emphasize the necessity of making the MRI more accessible to CIED patients, also in the case of MR non-conditional systems or when the thorax MR imaging is clinically reasonable. This goal should be achieved by increasing the number of centers complying with respective recommendations and applying protocols that would guarantee the highest safety level.
Future directions: Further studies are warranted to assess safety issues related to the main current contraindication to MRI, i.e., the presence of abandoned leads.
Keywords
Magnetic resonance imaging, Brain and thoracic spine MR imaging, MR conditional cardiac implantable, electronic devices, MR non-conditional cardiac, implantable electronic devices, Safety recommendations
About this articleTitle
State-of-the-art approach towards magnetic resonance imaging of the nervous system structures in patients with cardiac implantable electronic devices
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
652-656
Published online
2019-11-05
Page views
414
Article views/downloads
382
Pubmed
Bibliographic record
Neurol Neurochir Pol 2018;52(6):652-656.
Keywords
Magnetic resonance imaging
Brain and thoracic spine MR imaging
MR conditional cardiac implantable
electronic devices
MR non-conditional cardiac
implantable electronic devices
Safety recommendations
Authors
Katarzyna Gniadek-Olejniczak
Karol Makowski
Adam Olszewski
Kazimierz Tomczykiewicz
Andrzej Krawczyk
Józef Mróz
