The Current Status Of Magnetic Resonance Imaging In Patients With Magnetic Resonance Imaging-conditional Pacemaker

ObjectiveThe aim of this study was to evaluate the demographic characteristics of patients undergoing magnetic resonance imaging in patients with magnetic resonance imaging-conditional pacemaker(MRI-conditional pacemaker),and to explore the most suitable candidates for MRI-conditional pacemakers.The safety of MRI in this population was analyzed by evaluating pacing parameters before and after MRI examination,and the reasons of final unfinished MRI examination were also investigated.MethodsWe retrospectively enrolled consecutive patients who had received MRI-conditional pacemaker implantation from January 2012 to July 2017 in Fuwai Hospital.The baseline clinical characteristics were collected,and all patients were prospectively followed by telephone or clinic visiting.The MRI examination and related adverse events,reasons of final unfinished MRI examination were collected.The clinical features were compared between patients received MRI and those not receiving MRI examination.The pacing parameters before and after MRI examination were also investigated.ResultsA total of 524 patients with MRI-conditional pacemakers were included in the study.There were 114(21.8%)patients who had undergone MRI examination before pacemaker implantation,and 52 of them(45.6%)had received head and neck MRI check.During an average follow-up of 29 months,there were 62 patients(11.8%)had clinical MRI requirements,in which head and neck MRI examination were the most demanding(n=31,50.0%),MRI examination on other body parts showed relatively lower requirements:thoracic(n=14,22.6%),lumbar and abdominal(n=10,16.1%),and extremities(n=7,11.3%),respectively.However,only 15 patients(24.2%)had finally completed the MRI examination.As compared with patients had not received MRI,patients received MRI had a higher prevalence of cerebrospinal disease(6.4%vs 1.8%,P-0.007).The cerebrospinal disease with need for MRI examination included myasthenia gravis,Parkinson’s syndrome,cerebral pcdsy,spinal stenosis,Alzheimer’s disease,epilepsy,and pituitary tumor.No adverse events,such as arrhythmia or chest pain,in the MRI examination were occurred in the 15 patients.Pacing parameters remained stable before and after the MRI examination in 11 patients,and the other 4 patients did not received pacing test.The reasons for 75.8%(47/62)of patients in this cohort who had the MRI examination plan and finally did not have MRI examination were as follows:38.7%(24/62)for fear of potential risk,22.6%(14/62)chose other examinations instead of MRI,14.5%(9/62)gave up because the hospital refused to perform MRI examination because of their special consideration.ConclusionsPatients with a history of cerebrospinal disease have a clear needs for MRI and might be the most beneficial population for MRI-conditional pacemakers.Patients implanted with MRI-conditional pacemakers can perform MRI examinations safely,however,more than 3/4 ofpatients with requirement for MRI examination failed to perform MRI becauseof various obstacles in real-world clinical practice.