Performing MRI on patients with MRI-conditional and non-conditional cardiac implantable electronic devices: an update for radiologists

Research output: Contribution to journalReview article

Abstract

Pacemakers and implantable cardioverter defibrillators are commonly encountered in clinical practice, and entails special consideration when magnetic resonance imaging (MRI) is required. It is estimated that 50–75% of patients with cardiac implantable electronic devices (CIED) will have an indication for MRI during their lifetime. Radiologists may want to recommend MRI or may be consulted about the need to perform MRI in a patient with a CIED, at which point they may need to approve or at least provide guidance as to whether MRI may be performed safely. Even in situations where final clearance will not be provided by the radiologist, he or she can provide valuable information by reviewing radiographs and determining (a) whether a device is MRI-conditional and MRI may ultimately be permitted, (b) is not MRI-conditional and MRI using the standard workflow will therefore not be approved, or (c) when additional information will clearly be required. CIED identification and verification of leads can be accomplished through review of the medical record and/or evaluation of a chest radiograph. In patients with MRI-conditional CIEDs (as well as with legacy CIEDs in those institutions that perform MRI of these patients), specific imaging protocols must be adhered to in order to prevent death or injury to the patient or damage to the device. In this update, we provide details regarding the above topics and provide an algorithm for integrating this information into a clinical workflow to efficiently triage patients with CIEDs who are being considered for MRI.

Original languageEnglish (US)
JournalClinical Radiology
DOIs
StateAccepted/In press - Jan 1 2019

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Magnetic Resonance Imaging
Equipment and Supplies
Workflow
Radiologists
Implantable Defibrillators
Triage
Medical Records
Thorax
Wounds and Injuries

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Performing MRI on patients with MRI-conditional and non-conditional cardiac implantable electronic devices: an update for radiologists",
abstract = "Pacemakers and implantable cardioverter defibrillators are commonly encountered in clinical practice, and entails special consideration when magnetic resonance imaging (MRI) is required. It is estimated that 50–75{\%} of patients with cardiac implantable electronic devices (CIED) will have an indication for MRI during their lifetime. Radiologists may want to recommend MRI or may be consulted about the need to perform MRI in a patient with a CIED, at which point they may need to approve or at least provide guidance as to whether MRI may be performed safely. Even in situations where final clearance will not be provided by the radiologist, he or she can provide valuable information by reviewing radiographs and determining (a) whether a device is MRI-conditional and MRI may ultimately be permitted, (b) is not MRI-conditional and MRI using the standard workflow will therefore not be approved, or (c) when additional information will clearly be required. CIED identification and verification of leads can be accomplished through review of the medical record and/or evaluation of a chest radiograph. In patients with MRI-conditional CIEDs (as well as with legacy CIEDs in those institutions that perform MRI of these patients), specific imaging protocols must be adhered to in order to prevent death or injury to the patient or damage to the device. In this update, we provide details regarding the above topics and provide an algorithm for integrating this information into a clinical workflow to efficiently triage patients with CIEDs who are being considered for MRI.",
author = "A. Cunqueiro and Lipton, {M. L.} and Dym, {R. J.} and Jain, {V. R.} and J. Sterman and Scheinfeld, {M. H.}",
year = "2019",
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AU - Cunqueiro, A.

AU - Lipton, M. L.

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AU - Jain, V. R.

AU - Sterman, J.

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N2 - Pacemakers and implantable cardioverter defibrillators are commonly encountered in clinical practice, and entails special consideration when magnetic resonance imaging (MRI) is required. It is estimated that 50–75% of patients with cardiac implantable electronic devices (CIED) will have an indication for MRI during their lifetime. Radiologists may want to recommend MRI or may be consulted about the need to perform MRI in a patient with a CIED, at which point they may need to approve or at least provide guidance as to whether MRI may be performed safely. Even in situations where final clearance will not be provided by the radiologist, he or she can provide valuable information by reviewing radiographs and determining (a) whether a device is MRI-conditional and MRI may ultimately be permitted, (b) is not MRI-conditional and MRI using the standard workflow will therefore not be approved, or (c) when additional information will clearly be required. CIED identification and verification of leads can be accomplished through review of the medical record and/or evaluation of a chest radiograph. In patients with MRI-conditional CIEDs (as well as with legacy CIEDs in those institutions that perform MRI of these patients), specific imaging protocols must be adhered to in order to prevent death or injury to the patient or damage to the device. In this update, we provide details regarding the above topics and provide an algorithm for integrating this information into a clinical workflow to efficiently triage patients with CIEDs who are being considered for MRI.

AB - Pacemakers and implantable cardioverter defibrillators are commonly encountered in clinical practice, and entails special consideration when magnetic resonance imaging (MRI) is required. It is estimated that 50–75% of patients with cardiac implantable electronic devices (CIED) will have an indication for MRI during their lifetime. Radiologists may want to recommend MRI or may be consulted about the need to perform MRI in a patient with a CIED, at which point they may need to approve or at least provide guidance as to whether MRI may be performed safely. Even in situations where final clearance will not be provided by the radiologist, he or she can provide valuable information by reviewing radiographs and determining (a) whether a device is MRI-conditional and MRI may ultimately be permitted, (b) is not MRI-conditional and MRI using the standard workflow will therefore not be approved, or (c) when additional information will clearly be required. CIED identification and verification of leads can be accomplished through review of the medical record and/or evaluation of a chest radiograph. In patients with MRI-conditional CIEDs (as well as with legacy CIEDs in those institutions that perform MRI of these patients), specific imaging protocols must be adhered to in order to prevent death or injury to the patient or damage to the device. In this update, we provide details regarding the above topics and provide an algorithm for integrating this information into a clinical workflow to efficiently triage patients with CIEDs who are being considered for MRI.

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