Prashant Nair, Ariel Roguin, 206
“Magnetic Resonance Imaging in patients with ICDs and Pacemakers”
(if patient is an inpatient, it must be done before the patient returns to the floor).
An interrogation of the pacemaker or ICD will be performed 3 months after the exam to measure
thresholds (and other measurements).
Patient Care:
An ACLS certified Cardiology physician, nurse practioner or physician assistant, or alternatively,
an ACLS certified senior resident, fellow or attending physician of the primary care team will be
present at the MR-console during the entire exam to monitor the patient.
A pacemaker programmer will be present at the MR-scanner.
The patient will be monitored with ECG and pulse oximetry during the entire exam
A crashcart with an external defibrillator-pacemaker (not AED) must be present at the MR-
scanner.
A designated cardiologist needs to be within 5 minutes in of the MR-scanner.
References
1. Pinski SL, Trohman RG: Interference in implanted cardiac devices, Part II. Pacing Clin
Electrophysiol 2002; 25: 1496-1509.
2. Niehaus M, Tebbenjohanns J. Electromagnetic interference in patients with implanted
pacemakers or cardioverter-defibrillators. Heart 2001; 86: 246-248.
3. Hundley WG, Morgan TM, Neagle CM, et al. Magnetic resonance imaging determination of
cardiac prognosis. Circulation. 2002 ;106: 2328-2333.
4. Gerber BL, Garot J, Bluemke DA, Wu KC, Lima JA. Accuracy of contrast-enhanced magnetic
resonance imaging in predicting improvement of regional myocardial function in patients after
acute myocardial infarction. Circulation. 2002;106:1083-1089.
5. Kim RJ, Wu E, Rafael A, et al: The use of contrast-enhanced magnetic resonance imaging to
identify reversible myocardial dysfunction. N Engl J Med. 2000; 343:1445-1453.
6. Klein C, Nekolla SG, Bengel FM, et al: Assessment of myocardial viability with contrast-
enhanced magnetic resonance imaging: comparison with positron emission tomography.
Circulation. 2002; 105:162-167.
7. Kalin R, Stanton MS: Current clinical issues for MRI scanning of pacemaker and defibrillator
patients. Pacing Clin Electrophysiol. 2005;28:326-328.
8. Kanal E, Borgstede JP, Barkovich AJ et al: American College of Radiology White Paper on
MR safety:2004 update and revisions.AJR.2004; 182:1111-1114.
9. Erlebacher JA, Cahill PT, Pannizzo F, Knowles JR. Effect of magnetic resonance imaging on
DDD pacemakers. Am J Cardiol, 1986;57:437-440.
10. Hayes DL, Vlictstra RE: Pacemaker malfunction. Ann Intern Med. 1993;119:828-35
11. Pavlicek W, Geisinger M, Castle L, Borkowski GP, Meaney TF, Bream BL, Gallagher JH.
The effects of NMR on patients with cardiac pacemakers. Radiology, 1983;147:149-153.
Indian Pacing and Electrophysiology Journal (ISSN 0972-6292), 5(3): 197-209 (2005)
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