MRI can be performed safely in patients with selected implantable cardiac devices

Non-MRI conditional implantable cardioverter-defibrillators (ICDs) are able to appropriately detect and treat tachyarrhythmias after MRI, and no serious adverse effects on device function were observed. The findings were published in the Annals of Internal Medicine.

Joshua Ra and peers aimed to investigate whether non-MRI conditional ICDs have preserved shock function of arrhythmias after MRI. The study included 629 patients with non-MRI conditional ICDs enrolled consecutively between February 2003 and January 2015, who underwent MRI examinations in a 1.5 Tesla using a prespecified safety protocol. Clinical outcomes, including arrhythmia detection and treatment, generator or lead exchanges, adverse events, and death, were assessed through ICD interrogations after MRI. The median follow-up was 2.2 years from MRI to the latest available ICD interrogation before generator or lead exchange in 536 patients.

The key findings of this study were:

During the follow-up period, 4177 arrhythmia episodes were detected, and 97 patients received ICD shocks. Of these, 61 patients (10% of the total) had 130 spontaneous ventricular tachycardia or fibrillation events terminated by ICD shocks.

Among the 210 patients known to have died (33% of the total), three had cardiac arrhythmia deaths where shocks were indicated without direct evidence of device dysfunction. No serious adverse effects on device function were reported after MRI.

The findings of this study suggest that .

These results are consistent with previous studies that have shown that MRI does not have clinically important effects on the device parameters of non-MRI-conditional ICDs. However, it is important to note that the study was conducted in a single center, and larger multicenter studies are needed to confirm these findings.

Reference: 

Ra, J., Oberdier, M. T., Suzuki, M., Vaidya, D., Liu, Y., Hansford, R., McVeigh, D., Weltin, V., Tao, S., Thiemann, D. R., Nazarian, S., & Halperin, H. R. (2023). Implantable Defibrillator System Shock Function, Mortality, and Cause of Death After Magnetic Resonance Imaging. In Annals of Internal Medicine. American College of Physicians. https://doi.org/10.7326/m22-2653