By Mark S. Link, MD
Dr. Link is deputy editor with NEJM Journal Watch Cardiology, from which this story was adapted. Full coverage is available at the link below.
Patients with conventional pacemakers or implantable cardioverter-defibrillators (ICDs) who underwent magnetic resonance imaging (MRI) generally fared well, challenging conventional wisdom, suggests a New England Journal of Medicine study.
The MagnaSafe Registry, which had partial industry funding, prospectively enrolled 1500 patients with non-MRI-conditional devices who clinically needed nonthoracic MRI scans. The study had a strict protocol for appropriate programming, including DOO/VOO pacing in pacer-dependent patients with conventional pacemakers and inactivation of ICD therapies.
There were no deaths, lead failures, loss of capture, or ventricular arrhythmias. Six episodes of atrial fibrillation or flutter were noted. One ICD device could not be interrogated after MRI and needed immediate replacement. Partial electrical resets were observed six times. Minor changes in lead parameters were occasionally observed.
Comment: In this study, overall safety was quite good. These imaging studies were not without risks, but these were small. However, this study does not open the door to all MRI scans on all patients. The protocol’s patient criteria were strict. Yet, within these limits, it appears that MRIs can be performed in patients with pacemakers or ICDs.