Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T10:48:28.009Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiac MRI in patients with complex CHD following primary or secondary implantation of MRI-conditional pacemaker system

Published online by Cambridge University Press:  23 February 2015

Nadya Al-Wakeel ,
Darach O h-Ici ,
Katharina R. Schmitt ,
Daniel R. Messroghli ,
Eugénie Riesenkampff ,
Felix Berger ,
Titus Kuehne  and
Bjoern Peters
Nadya Al-Wakeel
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Darach O h-Ici
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Katharina R. Schmitt
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Daniel R. Messroghli
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Eugénie Riesenkampff
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Felix Berger
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Titus Kuehne
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Bjoern Peters*
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
*
Correspondence to: B. Peters, MD, Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Tel: +49 30 45932800; Fax: +49 30 45932900; E-mail: peters@dhzb.de
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

In patients with CHD, cardiac MRI is often indicated for functional and anatomical assessment. With the recent introduction of MRI-conditional pacemaker systems, cardiac MRI has become accessible for patients with pacemakers. The present clinical study aims to evaluate safety, susceptibility artefacts, and image reading of cardiac MRI in patients with CHD and MRI-conditional pacemaker systems.

Material and methods

CHD patients with MRI-conditional pacemaker systems and a clinical need for cardiac MRI were examined with a 1.5-T MRI system. Lead function was tested before and after MRI. Artefacts and image readings were evaluated using a four-point grading scale.

Results

A total of nine patients with CHD (mean age 34.0 years, range 19.5–53.6 years) received a total of 11 cardiac MRI examinations. Owing to clinical indications, seven patients had previously been converted from conventional to MRI-conditional pacemaker systems. All MRI examinations were completed without adverse effects. Device testing immediately after MRI and at follow-up showed no alteration of pacemaker device and lead function. Clinical questions could be addressed and answered in all patients.

Conclusion

Cardiac MRI can be performed safely with high certainty of diagnosis in CHD patients with MRI-conditional pacemaker systems. In case of clinically indicated lead and box changing, CHD patients with non-MRI-conditional pacemaker systems should be considered for complete conversion to MRI-conditional systems.

Keywords

CHDcardiac MRIMRIMRI-conditional pacemaker
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 2 , February 2016 , pp. 306 - 314
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Walsh, EP. Practical aspects of implantable defibrillator therapy in patients with congenital heart disease. Pacing Clin Electrophysiol 2008; 31 (Suppl 1): S38–S40.Google Scholar
2. Martin, ET, Coman, JA, Shellock, FG, Pulling, CC, Fair, R, Jenkins, K. Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla. J Am Coll Cardiol 2004; 43: 1315–1324.Google Scholar
3. Sutton, R, Kanal, E, Wilkoff, BL, et al. Safety of magnetic resonance imaging of patients with a new Medtronic EnRhythm MRI SureScan pacing system: clinical study design. Trials 2008; 9: 68.Google Scholar
4. Bonello, B, Kilner, PJ. Review of the role of cardiovascular magnetic resonance in congenital heart disease, with a focus on right ventricle assessment. Arch Cardiovasc Dis, 105: 605–613.Google Scholar
5. Fratz, S, Chung, T, Greil, GF, et al. Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease. J Cardiovasc Magn Reson 2013; 15: 51.Google Scholar
6. Kilner, PJ. The role of cardiovascular magnetic resonance in adults with congenital heart disease. Prog Cardiovasc Dis 2011; 54: 295–304.Google Scholar
7. Sasaki, T, Hansford, R, Zviman, MM, et al. Quantitative assessment of artifacts on cardiac magnetic resonance imaging of patients with pacemakers and implantable cardioverter-defibrillators. Circ Cardiovasc Imaging 2011; 4: 662–670.Google Scholar
8. Naehle, CP, Kreuz, J, Strach, K, et al. Safety, feasibility, and diagnostic value of cardiac magnetic resonance imaging in patients with cardiac pacemakers and implantable cardioverters/defibrillators at 1.5 T. Am Heart J, 161: 1096–1105.Google Scholar
9. Heatlie, G, Pennell, DJ. Cardiovascular magnetic resonance at 0.5 T in five patients with permanent pacemakers. J Cardiovasc Magn Reson 2007; 9: 15–19.Google Scholar
10. Vahlhaus, C, Sommer, T, Lewalter, T, et al. Interference with cardiac pacemakers by magnetic resonance imaging: are there irreversible changes at 0.5 Tesla? Pacing Clin Electrophysiol 2001; 24: 489–495.Google Scholar
11. Sommer, T, Vahlhaus, C, Lauck, G, et al. MR imaging and cardiac pacemakers: in-vitro evaluation and in-vivo studies in 51 patients at 0.5 T. Radiology 2000; 215: 869–879.CrossRefGoogle ScholarPubMed
12. Gimbel, JR, Bello, D, Schmitt, M, et al. Randomized trial of pacemaker and lead system for safe scanning at 1.5 Tesla. Heart Rhythm 2013; 10: 685–691.Google Scholar
13. Wollmann, CG, Steiner, E, Vock, P, Ndikung, B, Mayr, H. Monocenter feasibility study of the MRI compatibility of the Evia pacemaker in combination with Safio S pacemaker lead. J Cardiovasc Magn Reson 2012; 14: 67.CrossRefGoogle ScholarPubMed
14. Cohen, JD, Costa, HS, Russo, RJ. Determining the risks of magnetic resonance imaging at 1.5 tesla for patients with pacemakers and implantable cardioverter defibrillators. Am J Cardiol 2012; 110: 1631–1636.CrossRefGoogle ScholarPubMed
15. Nazarian, S, Hansford, R, Roguin, A, et al. A prospective evaluation of a protocol for magnetic resonance imaging of patients with implanted cardiac devices. Ann Intern Med 2011; 155: 415–424.CrossRefGoogle ScholarPubMed
16. Wilkoff, BL, Bello, D, Taborsky, M, et al. Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environment. Heart Rhythm, 8: 65–73.Google Scholar
17. Naehle, CP, Strach, K, Thomas, D, et al. Magnetic resonance imaging at 1.5-T in patients with implantable cardioverter-defibrillators. J Am Coll Cardiol 2009; 54: 549–555.Google Scholar
18. Pulver, AF, Puchalski, MD, Bradley, DJ, et al. Safety and imaging quality of MRI in pediatric and adult congenital heart disease patients with pacemakers. Pacing Clin Electrophysiol 2009; 32: 450–456.Google Scholar
19. Sommer, T, Naehle, CP, Yang, A, et al. Strategy for safe performance of extrathoracic magnetic resonance imaging at 1.5 tesla in the presence of cardiac pacemakers in non-pacemaker-dependent patients: a prospective study with 115 examinations. Circulation 2006; 114: 1285–1292.Google Scholar
20. Nazarian, S, Roguin, A, Zviman, MM, et al. Clinical utility and safety of a protocol for noncardiac and cardiac magnetic resonance imaging of patients with permanent pacemakers and implantable-cardioverter defibrillators at 1.5 tesla. Circulation 2006; 114: 1277–1284.Google Scholar
21. Wollmann, CG, Thudt, K, Kaiser, B, Salomonowitz, E, Mayr, H, Globits, S. Safe performance of magnetic resonance of the heart in patients with magnetic resonance conditional pacemaker systems: the safety issue of the ESTIMATE study. J Cardiovasc Magn Reson 2014; 16: 30.Google Scholar
22. Del Ojo, JL, Moya, F, Villalba, J, et al. Is magnetic resonance imaging safe in cardiac pacemaker recipients? Pacing Clin Electrophysiol 2005; 28: 274–278.Google Scholar
23. Gimbel, JR. Magnetic resonance imaging of implantable cardiac rhythm devices at 3.0 tesla. Pacing Clin Electrophysiol 2008; 31: 795–801.Google Scholar
24. Naehle, CP, Meyer, C, Thomas, D, et al. Safety of brain 3-T MR imaging with transmit-receive head coil in patients with cardiac pacemakers: pilot prospective study with 51 examinations. Radiology 2008; 249: 991–1001.Google Scholar
25. Luechinger, R, Zeijlemaker, VA, Pedersen, EM, et al. In vivo heating of pacemaker leads during magnetic resonance imaging. Eur Heart J 2005; 26: 376–383; discussion 325–377.Google Scholar
26. Schwitter, J, Kanal, E, Schmitt, M, et al. Impact of the Advisa MRI pacing system on the diagnostic quality of cardiac MR images and contraction patterns of cardiac muscle during scans: Advisa MRI randomized clinical multicenter study results. Heart Rhythm 2013; 10: 864–872.Google Scholar
27. Moons, P, Gewillig, M, Sluysmans, T, et al. Long term outcome up to 30 years after the Mustard or Senning operation: a nationwide multicentre study in Belgium. Heart 2004; 90: 307–313.Google Scholar
28. Ahmed, FZ, Morris, GM, Allen, S, Khattar, R, Mamas, M, Zaidi, A. Not all pacemakers are created equal: MRI conditional pacemaker and lead technology. J Cardiovasc Electrophysiol 2013; 24: 1059–1065.Google Scholar
29. Allen, HD, Beekman, RH 3rd, Garson, A Jr, et al. Pediatric therapeutic cardiac catheterization: a statement for healthcare professionals from the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 1998; 97: 609–625.Google Scholar
30. Andreassi, MG, Ait-Ali, L, Botto, N, Manfredi, S, Mottola, G, Picano, E. Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease. Eur Heart J 2006; 27: 2703–2708.Google Scholar