- Oral presentation
- Open Access
Clinical utility of cardiovascular magnetic resonance in patients with cardiac rhythm management devices
© Jariwala et al. 2016
- Published: 27 January 2016
- Cardiovascular Magnetic Resonance
- Late Gadolinium Enhancement
- Implantable Cardioverter Defibrillator
- Cardiac Sarcoidosis
- Cardiovascular Magnetic Resonance Image
Selected patients with cardiac rhythm management devices (CRMD) can safely undergo cardiovascular magnetic resonance (CMR). However, susceptibility artifacts from CRMD generator and leads can affect image quality, limiting the information provided by CMR. We sought to evaluate whether CMR of CRMD patients can provide clinically useful information that includes answering the clinical question, providing new findings, new diagnoses, or change in clinical management.
We studied 89 patients with CRMD who were evaluated for CMR from November 2012 through June 2015. Eighteen patients were excluded for various MRI contraindications. The remaining 71 patients completed the scan without complications. All CRMD were interrogated prior to the scan. For pacemaker dependent patients, asynchronous pacing was used during CMR. Device therapies were turned off for implantable cardioverter defibrillator (ICD) patients. CMR images were acquired on a 1.5 Tesla (Siemens Aera) scanner using standard sequences including single shot black blood imaging, cine with SSFP or FLASH, first pass perfusion, and late gadolinium enhancement (LGE). During the scan, patients were monitored with continuous vitals, ECG, oximetry, and voice contact. All CRMD were re-interrogated after the scan and original settings were restored. Images were evaluated using CMR42 (Circle Cardiovascular Imaging) software.
Baseline Clinical Characteristics
59.38 (± 12.95)
Body mass index (kg/m2)
29.54 (± 6.31)
Body surface area (m2)
2.09 (± 0.22)
Coronary artery disease
Previous ventricular arrhythmia ablation
Combined ischemic and non-ischemic scar
Arrhythmogenic right ventricular cardiomyopathy (ARVC)
Left ventricular involvement of ARVC
Rejected cardiac sarcoidosis
Accessory pulmonary vein
Right ventricular pseudoaneurysm
Severe aortic stenosis
Our results show that in carefully screened CRMD patients, CMR is safe, can answer the clinical question in vast majority of patients, and can provide new information to guide clinical management.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.