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Study finds 1.5-T MR exams are safe for patients with implanted cardiac devices

by John W. Mitchell , Senior Correspondent
Radiologists and cardiologists working together at Emory University Medical Center in Atlanta have observed no adverse effects conducting MR scans on patients with a wide-variety of vendor-implantable devices to regulate heart function. Their findings have been published in the September edition of the American Journal of Roentgenology.

"Our results show that with a multidisciplinary workflow, patients with conventional and MR conditional pacemakers and defibrillators can safely undergo MR imaging," Dr. Courtney Moreno, co-author and associate professor of radiology at the university, told HCB News.

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The study authors performed 113 1.5-T MR scans on patients with cardiac implantable electronic devices (CIEDs). This included 74 patients with pacemakers and 39 with cardiac defibrillators.

Device reprogramming was required in 63 percent of patients before the MR exam. Artifacts or objects related to the MR were described in only 3.5 percent of reports, and were associated with having the pulse generator in the view.

"These device-related artifacts slightly obscured soft tissues immediately adjacent to the control pack," said Moreno. "Three patients experienced transient mild symptoms during imaging, but these symptoms did not prevent completion of the imaging study."

According to Moreno, the study demonstrated that the 1.5 T MR procedure is safe for CIED patients, although close monitoring before and during the exam is required. She also said that the study should help encourage payors to revise their policies.

"Insurance coverage of MR in individuals with conventional devices is variable," she added. "We hope that our results, along with results of other, prior studies showing safety of MR in individuals with pacemakers and defibrillators will encourage insurers to cover these exams for their patients."

An estimated 400,000 pacemakers and implantable cardioverter-defibrillators are implanted each year in patients in the U.S., according to the American Roentgen Ray Society. More than three million Americans are living with such a CIED, and roughly half of them will have an indication for MR during the lifetime of their device.

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