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Strategy for Safe Performance of Extrathoracic Magnetic Resonance Imaging at 1.5 Tesla in the Presence of Cardiac Pacemakers in Non–Pacemaker-Dependent Patients: A Prospective Study With 115 Examinations

Sommer, Torsten, Naehle, Claas P., Yang, Alexander, Zeijlemaker, Volkert, Hackenbroch, Matthias, Schmiedel, Alexandra, Meyer, Carsten, Strach, Katharina, Skowasch, Dirk, Vahlhaus, Christian, Litt, Harold, Schild, Hans·2006·Circulation

Abstract

Background— The purpose of the present study was to evaluate a strategy for safe performance of extrathoracic magnetic resonance imaging (MRI) in non–pacemaker-dependent patients with cardiac pacemakers. Methods and Results— Inclusion criteria were presence of a cardiac pacemaker and urgent clinical need for an MRI examination. Pacemaker-dependent patients and those requiring examinations of the thoracic region were excluded. The study group consisted of 82 pacemaker patients who underwent a total of 115 MRI examinations at 1.5T. To minimize radiofrequency-related lead heating, the specific absorption rate was limited to 1.5 W/kg. All pacemakers were reprogrammed before MRI: If heart rate was <60 bpm, the asynchronous mode was programmed to avoid magnetic resonance (MR)–induced inhibition; if heart rate was >60 bpm, sense-only mode was used to avoid MR-induced competitive pacing and potential proarrhythmia. Patients were monitored with ECG and pulse oximetry. All pacemakers were interrogated immediately before and after the MRI examination and after 3 months, including measurement of pacing capture threshold (PCT) and serum troponin I levels. All MR examinations were completed safely. Inhibition of pacemaker output or induction of arrhythmias was not observed. PCT increased significantly from pre- to post-MRI ( P =0.017). In 2 of 195 leads, an increase in PCT was only detected at follow-up. In 4 of 114 examinations, troponin increased from a normal baseline value to above normal after MRI, and in 1 case (troponin pre-MRI 0.02 ng/mL, post-MRI 0.16 ng/mL), this increase was associated with a significant increase in PCT. Conclusions— Extrathoracic MRI of non–pacemaker-dependent patients can be performed with an acceptable risk-benefit ratio under controlled conditions and by taking both MR- and pacemaker-related precautions.

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Metadata

Authors
Sommer, T., Naehle, C. P., Yang, A., Zeijlemaker, V., Hackenbroch, M., Schmiedel, A., Meyer, C., Strach, K., Skowasch, D., Vahlhaus, C., Litt, H., & Schild, H.
Venue
Circulation
Published
2006-09-19
Volume
114
Issue
12
Pages
1285-1292
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2166413061
Cited by
256
References
0
FWCI
9.19
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Strategy for Safe Performance of Extrathoracic Magnetic Resonance Imaging at 1.5 Tesla in the Presence of Cardiac Pacemakers in Non–Pacemaker-Dependent Patients: A Prospective Study With 115 Examinations. https://app.cochat.ai/papers/10.1161/circulationaha.105.597013
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Sommer, T., Naehle, C. P., Yang, A., Zeijlemaker, V., Hackenbroch, M., Schmiedel, A., Meyer, C., Strach, K., Skowasch, D., Vahlhaus, C., Litt, H., & Schild, H. (2006). Strategy for Safe Performance of Extrathoracic Magnetic Resonance Imaging at 1.5 Tesla in the Presence of Cardiac Pacemakers in Non–Pacemaker-Dependent Patients: A Prospective Study With 115 Examinations. Circulation. https://doi.org/10.1161/circulationaha.105.597013

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