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(Radiology. 2000;215:869-879.)
© RSNA, 2000


Cardiac Imaging

MR Imaging and Cardiac Pacemakers: In Vitro Evaluation and in Vivo Studies in 51 Patients at 0.5 T1

Torsten Sommer, MD, Christian Vahlhaus, MD, Gerhard Lauck, MD, Alexander v. Smekal, MD, Marcus Reinke, MD, Ulrich Hofer, MD, Wolfgang Block, PhD, Frank Träber, PhD, Christian Schneider, MD, Jürgen Gieseke, PhD, Werner Jung, MD and Hans Schild, MD

1 From the Depts of Radiology (T.S., M.R., U.H., W.B., F.T., J.G., H.S.), Cardiology (C.V., W.J.), and Cardiovascular Surgery (C.S.), University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany; Dept of Cardiology, Marienhof, Koblenz, Germany (G.L.); and Dept of Diagnostic Radiology, University Hospital of Zurich, München, Germany (A.v.S.). From the 1996 RSNA scientific assembly. Received April 5, 1999; revision requested May 20; revision received September 1; accepted November 22. Address correspondence to T.S. (e-mail: t.sommer@uni-bonn.de).

PURPOSE: To evaluate the safety and feasibility of magnetic resonance (MR) imaging at 0.5 T in patients with implanted cardiac pacemakers.

MATERIALS AND METHODS: Twenty-one models of pacemakers and 44 pacemaker electrodes were exposed to in vitro MR imaging with continuous registration of pacemaker output and temperature at the lead tip. Prior to MR imaging examination, pacemakers were programmed to an asynchronous mode (A00, V00, or D00). Pacemakers were examined before and after MR imaging. Forty-four patients with implanted pacemakers underwent 51 MR imaging examinations under cardiologic surveillance, continuous electrocardiography, pulse oximetry, and capnographic monitoring.

RESULTS: MR imaging was safely performed in all patients. None of the pacemakers displayed a pacing dysfunction at MR imaging. No changes occurred in the programmed parameters in any device tested in vivo or in vitro. Maximum increases in the temperature at the lead tips were 8.90°C at a specific absorption rate (SAR) of 0.6 W/kg and 23.50°C under a worst-case radio-frequency (RF) heating condition with an SAR of 1.3 W/kg.

CONCLUSION: MR imaging at 0.5 T can be safely performed in patients with implanted pacemakers in carefully selected clinical circumstances when appropriate strategies (programming to an asynchronous mode, adequate monitoring techniques, limited RF exposure) are used.

Index terms: Heart, pacemakers, 51.43, 51.456 • Magnetic resonance (MR), experimental studies, **.1214112, **.121412, **.121413, **.121416, 51.43, 51.456 • Magnetic resonance (MR), safety, **.121411, **.121412, **.121413, **.121416, 51.43, 51.456 • Phantoms




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