Magnetic Resonance Imaging at 1.5-T in Patients With Implantable Cardioverter-Defibrillators
Claas P. Naehle, MD*,*,
Katharina Strach, MD*,
Daniel Thomas, MD*,
Carsten Meyer, MD*,
Markus Linhart, MD ,
Sascha Bitaraf, MD ,
Harold Litt, MD, PhD ,
Jörg Otto Schwab, MD,
Hans Schild, MD* and
Torsten Sommer, MD||
* Department of Radiology, University of Bonn, Bonn, Germany
Department of Cardiology, University of Bonn, Bonn, Germany
Department of Internal Medicine–Cardiology, Katholisches Klinikum Koblenz–Marienhof, Koblenz, Germany
Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
|| Department of Radiology, German Red Cross Hospital, Neuwied, Germany
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Figure 1 ICD Interrogation and Reprogramming Pre-MRI, Post-MRI, and at Follow-Up
ICD = implantable cardioverter-defibrillator; MRI = magnetic resonance imaging; 0X0 = sense-only mode.
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Figure 2 Midventricular Short-Axis MRIs of the Heart in a Patient With a Chronic MI
(Left) Steady-state free precession sequence, demonstrating wall thinning of the septal wall. (Right) Three-dimensional inversion recovery viability imaging, indicating the myocardial scar in the septum (black arrow). Note the susceptibility artifacts in the right ventricle due to the implantable cardioverter-defibrillator lead (open arrows) and in the pectoral region due to the implantable cardioverter-defibrillator (*). MI = myocardial infarction; MRI = magnetic resonance imaging.
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Figure 3 EGM Recorded at the Beginning of an MRI Sequence
Traces shown from top to bottom are: ventricular electrogram (EGM), shock coil EGM, and marker channel. Initial ventricular EGM shows regular sensing of intrinsic ventricular signals with correct classification as ventricular sensing (VS) (*). After the start of t scan sequence with radiofrequency pulses for image acquisition, oversensing of radiofrequency noise in the ventricular EGM occurs with classification as ventricular fibrillation (VF) (arrows) by the arrhythmia detection algorithm (see marker channel). MRI = magnetic resonance imaging.
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Figure 4 EGM With Sustained Oversensing of RF Noise by an ICD During MRI
Traces shown from top to bottom are ventricular electrogram (EGM), shock coil EGM, and marker channel. Radiofrequency (RF) noise (ventricular channel, top trace) is classified as ventricular fibrillation (VF) (arrows) by the arrhythmia detection algorithm (see marker channel). However, no therapy delivery was attempted as the device was reprogrammed to a monitor only mode (*) before MRI. Abbreviations as in Figure 1.
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