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Do we need MR conditional pacemakers?


Luechinger, R; Duru, F (2010). Do we need MR conditional pacemakers? Cardiovascular Medicine, 13(2):70-74.

Abstract

Magnetic resonance imaging (MRI) is a widely accepted
tool for the diagnosis of a variety of disease states.
However, due to safety concerns the presence of an implanted
cardiac pacemaker is considered to be a contraindication
to MRI in most medical centres. The
increasing number of implanted pacemakers and the
estimated over 50% probability that a pacemaker patient
may be a candidate for an MRI increase the need
for safe scanning of pacemaker patients. Over the last
ten years a major effort has been made to understand
the potential risks. The influences from the three electromagnetic
fields on pacemakers are versatile and will
be summarised. The research in this area has helped to
predict the risks of an MRI scan in patients with conventional
pacemakers, and has also stimulated pacemaker
manufacturers to improve their devices with the
goal of providing MR conditional devices. Since autumn
2008 the first approved MR conditional pacemakers
have been on the market and other devices are likely to
follow this trend.
However, the vast majority of devices are still not
approved for MRI, a situation which will take several
years to change. It is thus important that a solution be
also found for these patients. Several studies including
over 500 patients with a pressing need for MRI have
been performed at different experienced centres. On
the basis of those data various organisations in MRI
fields have proposed guidelines for MRI in patients who
fulfill given requirements. However, at present, non-
MRI modalities should be considered, whenever possible,
for diagnosis in pacemaker recipients with conventional
devices. If other imaging modalities are not
adequate, MRI with careful monitoring and preparation
for adverse events may be considered only at experienced
centres. With the wider availability of MR
conditional devices, the risks of MRI are greatly reduced
and non-tertiary centres will be able to perform
these investigations. In any case, rapid progress in the
field of MR conditional pacing is desirable.

Magnetic resonance imaging (MRI) is a widely accepted
tool for the diagnosis of a variety of disease states.
However, due to safety concerns the presence of an implanted
cardiac pacemaker is considered to be a contraindication
to MRI in most medical centres. The
increasing number of implanted pacemakers and the
estimated over 50% probability that a pacemaker patient
may be a candidate for an MRI increase the need
for safe scanning of pacemaker patients. Over the last
ten years a major effort has been made to understand
the potential risks. The influences from the three electromagnetic
fields on pacemakers are versatile and will
be summarised. The research in this area has helped to
predict the risks of an MRI scan in patients with conventional
pacemakers, and has also stimulated pacemaker
manufacturers to improve their devices with the
goal of providing MR conditional devices. Since autumn
2008 the first approved MR conditional pacemakers
have been on the market and other devices are likely to
follow this trend.
However, the vast majority of devices are still not
approved for MRI, a situation which will take several
years to change. It is thus important that a solution be
also found for these patients. Several studies including
over 500 patients with a pressing need for MRI have
been performed at different experienced centres. On
the basis of those data various organisations in MRI
fields have proposed guidelines for MRI in patients who
fulfill given requirements. However, at present, non-
MRI modalities should be considered, whenever possible,
for diagnosis in pacemaker recipients with conventional
devices. If other imaging modalities are not
adequate, MRI with careful monitoring and preparation
for adverse events may be considered only at experienced
centres. With the wider availability of MR
conditional devices, the risks of MRI are greatly reduced
and non-tertiary centres will be able to perform
these investigations. In any case, rapid progress in the
field of MR conditional pacing is desirable.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
04 Faculty of Medicine > Institute of Biomedical Engineering
Dewey Decimal Classification:170 Ethics
610 Medicine & health
Language:English
Date:2010
Deposited On:17 Jan 2011 18:16
Last Modified:05 Apr 2016 14:26
Publisher:EMH Swiss Medical Publishers
ISSN:1423-5528
Official URL:http://www.cardiovascular-medicine.ch/pdf/2010/2010-02/2010-02-089.PDF
Permanent URL: https://doi.org/10.5167/uzh-39583

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