901-24 Safe Magnetic Resonance Imaging of Pacemaker Patients

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Most authorities feel MRI of pacemaker (PM) patients is absolutely contraindicated. We collected data on institutional practices regarding MRI of PM patients and identified previously unreported PM patients who have undergone MRI through a survey of cardiologists (n = 106) and radiologists (n = 86) at predominantly tertiary care (92%) institutions. Forty-one % (n = 78) of the 192 surveys were returned over a 2 month period. Practice policies varied, with 33% of cardiologists responding they would perform MRI if needed and 93% of radiologists completely prohibiting MRI in PM patients. We identified 19 patients who were scanned a total of 20 times. A variety of strategies were suggested or used to help scan PM patients safely, including avoiding MRI of PM dependent patients, reprogramming the PM to asynchronous or non-capture mode, having PM specialists present and use of enhanced non-invasive monitoring. A variety of unipolar, bipolar, single and dual chamber PM underwent MRI inclUding models from CPI, Intermedics, Medtronic, Siemens Pacesetter, and Telectronics. Sixteen of the scans occurred without the knowledge that the patient had a pacemaker. Seventeen scanning events occurred “without apparent consequence” to the patient or PM. One unmonitored PM patient died who was inadvertently scanned. One patient felt discomfort at the PM pocket, and one patient developed a rapid heart rate during MRI. These latter two patients were unharmed after the MRI was aborted. All of the PM interrogated afterward were found unaffected. The results highlight attitudinal differences regarding the perceived safety of scanning PM patients. PM patients may safely undergo MRI if appropriate strategies are employed that account for potential ill effects on the PM by MRI.