Clinical value of cardiovascular magnetic resonance in patients with MR-conditional pacemakers

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Raphael, Claire E., Vassiliou, Vassilis ORCID: https://orcid.org/0000-0002-4005-7752, Alpendurada, Francisco, Prasad, Sanjay K., Pennell, Dudley J. and Mohiaddin, Raad H. (2016) Clinical value of cardiovascular magnetic resonance in patients with MR-conditional pacemakers. European Heart Journal – Cardiovascular Imaging, 17 (10). pp. 1178-1185. ISSN 2047-2404

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Abstract

Aims: Magnetic resonance (MR) conditional pacemakers are increasingly implanted into patients who may need cardiovascular MR (CMR) subsequent to device implantation. We assessed the added value of CMR for diagnosis and management in this population. Methods and results: CMR and pacing data from consecutive patients with MR conditional pacemakers were retrospectively reviewed. Images were acquired at 1.5 T (Siemens Magnetom Avanto). The indication for CMR and any resulting change in management was recorded. The quality of CMR was rated by an observer blinded to clinical details, and data on pacemaker and lead parameters were collected pre- and post-CMR. Seventy-two CMR scans on 69 patients performed between 2011 and 2015 were assessed. All scans were completed successfully with no significant change in lead thresholds or pacing parameters. Steady-state free precession (SSFP) cine imaging resulted in a greater frequency of non-diagnostic imaging (22 vs. 1%, P < 0.01) compared with gradient echo sequences (GRE). Right-sided pacemakers were associated with less artefact than left-sided pacemakers. Late gadolinium enhancement imaging was performed in 59 scans with only 2% of segments rated of non-diagnostic quality. The CMR data resulted in a new diagnosis in 27 (38%) of examinations; clinical management was changed in a further 18 (25%). Conclusions: CMR in patients with MR conditional pacemakers provided diagnostic or management-changing information in the majority (63%) of our cohort. The use of gradient echo cine sequences can reduce rates of non-diagnostic imaging. Right-sided device implantation may be considered in patients likely to require CMR examination.

Item Type: Article
Uncontrolled Keywords: cardiovascular magnetic resonance,cmr,pacemaker,conditional,ppm
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: Pure Connector
Date Deposited: 06 Jul 2017 05:06
Last Modified: 19 Oct 2023 02:00
URI: https://ueaeprints.uea.ac.uk/id/eprint/64034
DOI: 10.1093/ehjci/jev305

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