Magnetic resonance imaging in patients with a subcutaneous implantable cardioverter-defibrillator

Europace. 2015 May;17(5):761-6. doi: 10.1093/europace/euu377. Epub 2015 Feb 16.

Abstract

Aims: Our aim was to evaluate the potential for safely imaging patients with a new type of implantable cardioverter-defibrillator called the subcutaneous implantable cardioverter-defibrillator (S-ICD) in a 1.5 T magnetic resonance imaging (MRI) scanner. With the increasing number of patients with cardiac implantable devices who are indicated for MRI, there is a growing need for establishing MRI compatibility of cardiac implantable devices.

Methods and results: Patients with implanted S-ICD systems underwent one or more types of anatomical MRI scans. The S-ICD was programmed off and patients were monitored throughout the imaging procedure. Device function was evaluated pre- and post-scan. Patients were asked to report immediately any pain, torqueing movement, or heating sensation in the area of the pocket or electrode. Fifteen patients underwent a total of 22 examinations at 1.5 T. Scans included brain, spine, knee, and heart. Two patients were re-scanned due to complaints of heating over the can during lumbar scans, which was caused by a thermistor probe placed on the skin to measure skin temperature. All the remaining scans occurred without incident. No evidence of device malfunction was observed.

Conclusion: This study is the first to domonstrate the feasibility of exposing S-ICD patients to MRI using the scanning and monitoring protocol described. More data are required to support S-ICD as a MRI conditional device.

Keywords: Implantable defibrillator; Magnetic resonance imaging; Subcutaneous S-ICD.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Artifacts
  • Defibrillators, Implantable* / adverse effects
  • Electric Countershock / adverse effects
  • Electric Countershock / instrumentation*
  • Feasibility Studies
  • Female
  • Hot Temperature / adverse effects
  • Humans
  • Magnetic Resonance Imaging* / adverse effects
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prosthesis Design
  • Prosthesis Failure
  • Risk Factors
  • Young Adult