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The Safety of Magnetic Resonance Imaging in Patients With Pacemakers or Defibrillators FREE

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The full report is titled “A Prospective Evaluation of a Protocol for Magnetic Resonance Imaging of Patients With Implanted Cardiac Devices.” It is in the 4 October 2011 issue of Annals of Internal Medicine (volume 155, pages 415-424). The authors are S. Nazarian, R. Hansford, A. Roguin, D. Goldsher, M.M. Zviman, A.C. Lardo, B.S. Caffo, K.D. Frick, M.A. Kraut, I.R. Kamel, H. Calkins, R.D. Berger, D.A. Bluemke, and H.R. Halperin.

Ann Intern Med. 2011;155(7):I-34. doi:10.7326/0003-4819-155-7-201110040-00002
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What is the problem and what is known about it so far?

Pacemakers and defibrillators are battery-operated devices that are implanted under the skin of patients with certain heart problems. They are used to treat specific problems with the electrical impulses that control how the heart beats, or to stop abnormally fast heart rhythms. Magnetic resonance imaging (MRI) is a specialized method of taking pictures of the body. Because of concerns that doing MRI might interfere with the normal function of a pacemaker or defibrillator, however, it has been assumed to be unsafe in patients with these devices.

Why did researchers do this particular study?

To see whether it might be safe for patients with pacemakers or defibrillators to have MRI.

Who was studied?

438 patients with either a pacemaker or defibrillator who needed to MRI.

How was the study done?

Doctors and nurses with expertise in caring for patients with pacemakers and defibrillators monitored the functioning of each patient's device during MRI; immediately after MRI; and, when possible, about 6 months later. The settings of pacemakers or defibrillators were adjusted before MRI and then restored to their usual settings immediately afterward.

What did the researchers find?

Three patients experienced a transient change in the functioning of their heart devices during MRI. Only 1 patient felt anything unusual (a pulling sensation), and in that case the MRI was stopped without any additional problems. Magnetic resonance imaging was completed safely in all other patients. Although some changes were seen in the operation of some pacemakers and defibrillators immediately after MRI or months later, none of them required treatment or changes in the patient's care.

What were the limitations of the study?

Although many types of pacemakers and defibrillators were included, only a small number of each type was studied, and some devices were not studied at all.

What are the implications of the study?

Some patients with pacemakers or defibrillators can safely have MRI, provided that they are carefully evaluated beforehand and that they are monitored during and after the test by doctors and nurses with expertise in this area.





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