부산대학교 도서관

Background: Observational studies have explored MR scanning of patients with cardiac implantable electronic devices (CIEDs) not FDA approved for MR scanning (“non-conditional”). However, concerns remain that thoracic MR scanning may pose a higher risk, as data are limited and the largest published registry, MagnaSafe, excluded thoracic scans. This large single center prospective cohort study examines the safety of MR scanning of thoracic versus non-thoracic regions in CIED patients.Methods: CIED patients were prospectively enrolled and underwent MR scanning (1.5 Tesla) without restriction to region, utilizing an institutional protocol that included CIED evaluation prior to and immediately post imaging and heart rhythm monitoring throughout scanning. Regression analysis with random effects to account for multiple scans was used to determine if changes in CIED parameters were dependent on region scanned (thoracic versus non-thoracic; p-value <0.05 for statistical significance).Results: 248 patients (62.5% male, age 65 ± 15 years) underwent 339 MR scans: 122 were thoracic (73 cardiac, 8 thorax, 41 cervical or thoracic spine) and 217 non-thoracic (74 brain, 77 abdomen, 29 pelvis, 16 extremities, 21 lumbar spine). There were no significant differences between pre and post-parameters for battery voltage, P or R wave sensing, atrial or ventricular lead impedances or pacing capture voltage threshold, and no dependence on region scanned. Scatter plots of pre and post parameters according to region scanned are shown (Figure). One power on reset occurred in a patient that underwent a cardiac MRI and the CIED was successfully reprogrammed. There were no clinical adverse effects or arrhythmias.Conclusion: CIED parameters did not significantly change post MR scan, regardless of region scanned (thoracic versus non-thoracic), with, no arrhythmias or clinical adverse effects in this prospective cohort. An institutional protocol remains essential to promote safety.