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- Publisher
- Oxford University Press
- Copyright
- © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
- eISSN
- 2514-2119
- DOI
- 10.1093/ehjcr/ytab198
- Publisher site
- See Article on Publisher Site
Abstract
BackgroundMagnetic resonance (MR) imaging (MRI) for patients with implantable cardiac devices is becoming more routine, with the development of MR conditional devices allowing more patients access to the imaging they need. However, for this to be performed safely, strict protocols must be followed necessitating close collaboration between cardiology and radiology departments. We present a case where mandatory device re-programming of a cardiac resynchronization therapy defibrillator device into MRI mode was not performed pre-scan leading to temporary device dysfunction with no clinical consequences.Case summaryA 72-year-old man presented to a device clinic for a routine device interrogation. An atrial tachycardia response episode was recorded at the same time as the patient reported having undergone an MRI scan at a local centre. The electrogram demonstrated temporary right ventricular loss of capture with standard output programming, and a short episode of oversensing on the atrial and ventricular channel which was not sustained for long enough to meet tachycardia detection.DiscussionWe demonstrate two potential electrophysiological effects of MRI on pacemakers, where the device had not been appropriately re-programmed pre-procedure. This illustrates that whilst MRI in patients with implantable cardiac devices is safe, strict protocols must be followed requiring robust multidisciplinary communication.
Journal
European Heart Journal - Case Reports – Oxford University Press
Published: Sep 21, 2021
Keywords: MRI; Pacemakers; Implantable cardioverter-defibrillator; Cardiac resynchronization defibrillator; Loss of capture; Programming; MRI safety; Case report