OAK BROOK – MRI scans can be done safely in patients with non-MRI compatible heart devices, including those who are pacemaker dependent or have abandoned leads, according to a study published in Radiology : Cardiothoracic Imaging
Millions of people around the world use implanted heart devices such as pacemakers and implantable automatic defibrillators (ICDs) to help control abnormal heart rhythms MRI scans are not recommended or prohibited in many of these people for fear that the strong scanner magnet does not heat the metal in the devices, potentially damaging heart tissue and damaging the devices
The US Food and Drug Administration (FDA) has identified a subset of implanted cardiac devices as conditional MRI, which means that they present no known danger under specified conditions Pacemakers or ICDs that do not not meet criteria are considered conditional non-MRI In these patients, clinicians are forced to choose between the removal of a necessary heart device or another potentially less effective imaging test
« While all devices implanted in patients today are MRI compatible, millions of people around the world, including many young people, have older devices that are considered incompatible, » said lead author of the study, Sanjaya K Gupta, Mré, of the Mid America Heart Institute of Saint Luke in Kansas City, Missouri « It is unfair to tell these people that they can’t get MRIs for the rest of their life «
Previous research has shown the safety of performing MRI scans in patients with conditional devices without MRI However, these studies did not include patients with ICD dependent on a pacemaker or patients whose heart will not work if the defibrillator is removed or stops working Other groups not considered in previous studies include patients undergoing chest and cardiac MRI scans and patients with abandoned or fractured leads, or wires that connect the device to the heart.
To develop a more complete picture of risk, Dr Gupta and his colleagues created the Magnetic Resonance Imaging in Unapproved Devices Patient Registry (PROMeNADe) They enrolled over 500 participants who had undergone a total of 608 MRI scans, including 61 cardiac MRI scans Participants included people from groups not considered in previous research
Patients had their device checked before and after each MRI and their vital signs were closely monitored by a nurse while they were scanned.The devices were put on asynchronous mode in pacemaker dependent patients before enter CT scan Patients with ICD had tachycardia therapies turned off during MRI
The results demonstrated that MRI scans – including chest MRI scans – can be performed safely in patients with pacemaker-dependent DCI and in patients with non-MR conditional devices or leads abandoned
« There were no adverse events », Dr Gupta said « The protocol worked wonderfully We had no problems with any of the patients and no damage to the devices »
The registry is now the largest series of MRI scans ever performed in pacemaker dependent ICD patients.It is also the second largest in patients with abandoned or fractured leads and the third largest in non-compatible devices
Results of a survey of physicians who had referred patients for MRI scans underscored the importance of exams According to responses from 150 physicians, MRI results changed the suspected diagnosis 25% of the time and changed the suspected prognosis in 26% of participants, with planned medical or surgical treatment changed 42% of the time
« We hope our work will add support to expand the FDA’s indications for devices considered MRI compatible, » Dr. Gupta said
The study was inspired, in part, by the case of a patient with a brain tumor who was unable to have badly needed MRI scans because her pacemaker was not under MRI condition Without MRI results allowing precise localization of the tumor, the patient had to undergo several risky surgeries
« This study took a lot of work, but it’s worth it considering all the lives involved, » Dr Gupta said « I feel like it makes a difference to a lot of people »
Dr Kamal Kant Kohli-MBBS, DTCD – a breast specialist with over 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli has joined Medical Dialogues as Editor-in-Chief of the Specialized Medical Dialogues section In addition to writing articles, as an editor, he proofreads and checks all medical content published on Medical Dialogues, including that from journals, studies, medical conferences, guidelines, etc Prior to joining Medical Dialogues, he held senior positions in the medical industry in India, including as Hony Secretary of the Delhi Medical Association as well as the Chairman of the Anti-Quackery Committee in Delhi and worked with many other medical advice in India Email: editorial @ medicaldialogues in Contact No 011-43720751
Magnetic Resonance Imaging, Medical Imaging, Health Care
World news – CA – MRI can be performed safely in patients with pacemakers and ICDs: study
SOURCE: https://www.w24news.com
