Significant Changes In battery And Lead Performance of CIED`s After MRI

Introduction-The presence of cardiovascular implantable electronic devices(CIED`s) has for long been considered a contraindication for MRI.
Nonetheless, due to recent trials advocating its relative safety, MRI has started being widely performed in patients with CIED.

Objective-To assess changes in lead and battery parameters of CIED`s after MRI and reveal risk factors for significant changes.

Method-Consecutive patients with CIED who underwent MRI were included in the study. Devices were interrogated pre and post scan to evaluate battery and lead performance. Appropriate pacing mode was set during imaging. The procedure was performed under constant monitoring and supervision.

Results-Prospectively collected data on 136 CIED`s implanted patients who underwent MRI between 2016 and 2019 in Hadassah hospital, were analyzed. Of whom, 110 had a pacemaker and 26 an ICD.

No deaths, lead failures, losses of capture, or ventricular arrhythmias occurred during MRI. We observed six cases(3.7%) of conversion to non-sensing mode(DOO),3 cases(2.2%) of loss of escape rhythm post scan and one case(0.73%) of new onset of atrial fibrillation.

Regression analysis indicated that programming of DOO mode during scan correlated independently with battery life decrease(p=.004), pacing threshold increase(p=.042) and sensing amplitudes reduction(p=.033).

Pacemakers appeared to be more prone to decrease in sensing amplitudes compared to ICD`s(p=.025). Non-MR-conditional CIED`s were found more liable to sensing amplitudes reduction compared to MR-conditionals(P=.017).

Linear correlation was noted between MRI duration and reduction in sensing amplitudes along with ventricular lead impedance increase(p=.034 .041 respectively) .Linear correlation between lead age and decrease in sensing amplitudes was also marked(p=.006).

No statistical significance was obtained in regard to manufacturing company or imaging site.

Conclusion-Despite relative safety of MRI in CIED`s implanted patients, significant changes in battery and lead parameters do occur. Device programming to non-sensing mode, MRI scan time and non-MR-condition appeared to be risk factors for such a change in this cohort.