MAGNETIC RESONANCE AND CARDIAC IMPLANTABLE DEVICES: A SAFE COMBINATION

Abstract

Abstract Despite guidelines the presence of a cardiac implantable device (CIED) in a magnetic resonance (MR) ambient raises fears and perplexities and generates the often inappropriate request for support from the electrophysiologist. From January 2019 to November 2023 all patients with a cardiac implantable device (CIED) undergoing magnetic resonance (MR) were evaluated. All CIEDS were classified into three subgroups: MR–conditional, MR–unsafe and "non MR–conditional" (catheters and generators MR–conditional but of different manufacturers). No implantable loop recorders were enrolled. We performed a device control immediately before and after the RM procedure. We analyzed the percentage variations of each parameter (sensing, impedance and pacing threshold) pre– and post–MR and the variation versus the latest or the subsequent ambulatory control. 151 patients were proposed to undergo MR. 16 patients underwent multiple exams. The districts explored from RM were head (47%), column (21%), breast (1%), heart (3%), abdomen (20%), prostate (2%) and arms (16%). The median age was 70 years old, and 102 patients were males. CIEDS were pacemaker in 67% (3 leadless and 1 CRT–P), 33% defibrillators (5 S–ICD and 10 CRT–D). 85% of the systems were classified as MR–conditional, 3% as MR–unsafe and 12% as "non MR–conditional". The percentage median variation of atrial and ventricular sensing, impedance and threshold during the exam was 0%. MR did not significantly modify the parameters considered. No adverse events arise at the end of MR or in the days after. In our experience, there is no need for the presence of the electrophysiologist during the procedure due to safety even in "non MRI–conditional" or MR–unsafe patients.