Five-Year Experience in Performing MRIs on Paediatric Patients with CIEDs (Cardiac Implantable Electronic Devices)

Abstract

Background: Potential interactions between cardiac implantable electronic device (CIED) systems and magnetic resonance imaging (MRI) have been reduced since the introduction of MRI conditional CIEDs and leads. Concerns about potential interactions often prevent patients with CIEDs from undergoing MRI. This abstract’s purpose is to describe our experience of performing MRIs on paediatric patients with conditional and non-conditional CIED systems. Methods: A retrospective data review was performed on all patients who underwent MRI at the Queensland Children’s Hospital with a CIED (pacemaker, implantable cardioverter defibrillator, implantable loop recorder) between February 2018 and December 2023. 14 regions (two brain, two lower extremities, five cardiac, five multi-region brain and spine) were imaged using MRI on 11 patients; one patient underwent three and one patient underwent two MRIs. Seven patients had conditional systems and four patients non-conditional systems. All non-conditional systems had epicardial leads and one a non-conditional device. Five patients (four with non-conditional systems) had MRI under general anaesthetic. Results: During MRI, no clinical events or symptoms occurred. All cardiac devices were interrogated pre and post MRI, and outpatient follow-up by the electrophysiology team. Post MRI no immediate changes were seen in any CIED system of any manufacturer, model or lead. Three-month post MRI one patient with a non-conditional device and epicardial lead showed increased right ventricular threshold (1.25V pre-MRI, 2.25V three-month post MRI); no further changes have been seen. Conclusion: Using appropriate precautions, and completing a benefit-risk analysis, MRI can be safely performed in paediatric patients with conditional and non-conditional CIED systems.