Effects of nuclear magnetic resonance imaging on cardiac pacemakers

Abstract

Patients with cardiac pacemakers are currently restricted from nuclear magnetic resonance imaging (MRI). The aim of the study was to analyze the influence of MRI on new generation pacemakers. Tests were performed using a phantom model with seven dual chamber and two single chamber systems in a 0.5 Tesla MRI scanner. Monitoring by telemetry and oscillography were used during the standard clinical scan sequences as well as a pacemaker inquiry after each sequence. Spin echo, gradient echo, and fast field echo sequences were performed with the following stimulation modes: VVI, VVIR, VOO, DDD, DDDR, and DOO. On entering the static magnetic field, the reed switch was activated followed by asynchronous stimulation. The subsequent scan showed no influence on the stimulation function nor on the pacemaker program. Event counter function remained intact. Pacemakers with automatic mode switching to demand pacing or programmed inactivation of the reed switch were triggered in the dual chamber mode and were inhibited in the one chamber mode during the scan. Alterations of pacemaker program or rapid pacing were not observed. MRI scan could induce voltage as high as intracardiac signals, but the stimulation threshold of the heart was not reached. Thus, pacemakers should be programmed in the asynchronous mode during scan to avoid inhibition and trigger mechanism.