A lot of care and attention should be taken when performing magnetic resonance imaging (MRI) in patients with a cardiac pacemaker, according to recent findings.

Dr. Henning Bovenschulte and his coauthors, including Prof. Dr. med. Liebig, from the University Hospital of Cologne (Germany), published their recent findings in the April 13, 2012, issue of the journal Deutsches Arzteblatt International. MRI is typically contraindicated in patients with a pacemaker (PM) or an implantable cardiac defibrillator (ICD), because of the risk of life-threatening events. The devices and their sensors may interact with the magnetic fields, disrupting the cardiac rhythm. Energy builds up in the electrode leads, which act as an antenna, and is discharged into the tissues around the tip of the electrode.

The published data, supplemented by the authors’ own data, yielded a total of 1043 patients with a PM or ICD who had undergone MRI. No life-threatening complications were observed. In 11 cases, electrical resetting of the device was needed, and a considerable increase in pacing threshold was seen in 16 cases.

In spite of the potential dangers, MRI is at times indicated in a seriously ill patient. Provided appropriate steps are taken to optimize the procedure, the benefits of MRI will clearly outweigh the risks, according to the investigators.

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