#whyCMR and Implantable devices:
👉Increasing rates of cardiac device implantation
👉Expanding indications for CMR
Need to deal with:
🥇Device compatibility
🥈Artifacts
🥉Stress perfusion
…where are we?
💫Here a tweetorial on CMR and devices!
Conditional or non conditional?
👉1.5T or 3T
👉 no deaths, lead failures, losses of capture, or ventricular arrhythmias during CMR in patients with non-MR conditional pacemakers or ICDs
👉only decrease in 1% in p wave amplitude (no clinically relevant)
What about abandon leads?
👉No major tachicardia
👉No major device malfunctioning
👉reports show that this should not be a controindication anymore
What about Artifacts?
👉Artifacts depends on:
🥇Number of leads
🥈Dimension of the generator
🥉Distance heart-generator
Loop recorder<PM<ICD<CRT-D
🚩LGE can suffer more from artifacts compared to cine or perfusion
Tips and Tricks for artifacts:
🚩See device position on scout images
🚩See artifacts on scout images
🚩Use GRE-cine or GRE-perfusion
🚩Use wideband LGE
Stress perfusion (SP) CMR:
👉SP CMR yields good image quality in patients with PM
👉SP CMR can help defining the prognosis of patients with PM
👉SP CMR yields good image quality also in patients with ICD
👉SP CMR is feasible and safe even in patients PM dependent
🥇check compatibility vs CMR indication (🚩 no issues reported for non conditional)
🥈check the device before scanning --> MR mode:
🧐 turn off ICD
🧐PM should be activated if >1% of atrial/ ventricular pacing
👉dont' be afraid of SP CMR!
🥉Turn off the MR mode after scanning
Bibliography: some useful papers, feel free to add!
pubmed.ncbi.nlm.nih.gov/35022037/
pubmed.ncbi.nlm.nih.gov/34274281/
pubmed.ncbi.nlm.nih.gov/34435642/
pubmed.ncbi.nlm.nih.gov/34031214/
pubmed.ncbi.nlm.nih.gov/31776746/
pubmed.ncbi.nlm.nih.gov/21641356/
pubmed.ncbi.nlm.nih.gov/30642645/
pubmed.ncbi.nlm.nih.gov/34378816/
@SCMRorg @HeartDocSubha @salernomdphd @purviparwani @AChoiHeart @vineetao17 @danilorenzatti @onco_cardiology @swleun2 @Doc_Tiger @vass_vassiliou @rajdoc2005 @AkhilNarangMD @okhaliquemd @AKallifatidis @drjenniferco_vu @kfarooqi @RayRcNita @AmroAlsaid @Ascatteia @MrinShettyMD
@MrinShettyMD @rooshaparikh @JStojanovskaMD @fabrizioricci @krishnapatel888 @hpatel824 @tiffchenMD @bennybristol @ydaryani @PushpaShivaram @rishk88 @Avanti0609 @DmmOsmany @BostjanBerlot @arzanauskaite @RAQuintMD @ecocardio_cl @rebeccakozor @eylemlevelt
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