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2021 Update on Safety of Magnetic Resonance Imaging: Joint Statement From Canadian Cardiovascular Society/Canadian Society for Cardiovascular Magnetic Resonance/Canadian Heart Rhythm Society

Authors :
Christine Villemaire
James A. White
Matthew T. James
D. Ian Paterson
Michael D. Hill
Secondary Panel
Laurence D. Sterns
Kate Hanneman
Douglas Wan
Atul Verma
Carmen Lydell
Jonathan Windram
Craig Butler
Idan Roifman
Anish Kirpalani
Primary Panel
L. Grosse-Wortmann
Rachel M. Wald
Kim A. Connelly
Jonathon Leipsic
Andrew M. Crean
Elsie T Nguyen
Jaimie Manlucu
Bradley Sarak
Roopinder K. Sandhu
Peter G. Guerra
Source :
Canadian Journal of Cardiology. 37:835-847
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Magnetic resonance imaging (MRI) is often considered the gold-standard test for characterizing cardiac as well as noncardiac structure and function. However, many patients with cardiac implantable electronic devices (CIEDs) and/or severe renal dysfunction are unable to undergo this test because of safety concerns. In the past 10 years, newer-generation CIEDs and gadolinium-based contrast agents (GBCAs) as well as coordinated care between imaging and heart rhythm device teams have mitigated risk to patients and improved access to MRI at many hospitals. The purpose of this statement is to review published data on safety of MRI in patients with conditional and nonconditional CIEDs in addition to patient risks from older and newer GBCAs. This statement was developed through multidisciplinary collaboration of pan-Canadian experts after a relevant and independent literature search by the Canadian Agency for Drugs and Technologies in Health. All recommendations align with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Key recommendations include: (1) the development of standardized protocols for patients with a CIED undergoing MRI; (2) patients with MRI nonconditional pacemakers and pacemaker dependency should be programmed to asynchronous mode and those with MRI nonconditional transvenous defibrillators should have tachycardia therapies turned off during the scan; and (3) macrocyclic or newer linear GBCAs should be used in preference to older GBCAs because of their better safety profile in patients at higher risk of nephrogenic systemic fibrosis.

Details

ISSN :
0828282X
Volume :
37
Database :
OpenAIRE
Journal :
Canadian Journal of Cardiology
Accession number :
edsair.doi.dedup.....1c33b3fba62d09bef91fa28dca9e55c0