From the Guidelines
Yes, a patient can undergo Magnetic Resonance Imaging (MRI) with an implantable loop recorder (ILR), but it depends on the specific type of ILR and adherence to certain conditions. Most modern loop recorders, such as the Medtronic Reveal LINQ or Abbott Confirm Rx, are MRI-conditional, meaning they can safely undergo MRI scans under specific conditions 1. These conditions typically include using specific MRI machines (usually 1.5 or 3 Tesla), following particular scanning parameters, and sometimes waiting a certain period after implantation (often 4-6 weeks) 2.
Key Considerations for MRI with ILR
- Inform your healthcare provider about your loop recorder to verify its MRI compatibility
- The radiologist and cardiologist must coordinate to ensure proper settings are used during the scan
- Some loop recorders may temporarily stop recording during the MRI and automatically resume afterward
- Modern loop recorders are designed with materials and electronics that minimize interaction with the strong magnetic fields of MRI machines, allowing patients to safely receive important diagnostic imaging without removing the monitoring device 1
Precautions and Guidelines
- Exclude patients with leads that have not matured (<6 weeks since implantation) and those with epicardial and abandoned leads 2
- Programme an asynchronous pacing mode in PM-dependent patients to avoid inappropriate inhibition of pacing due to detection of electromagnetic interference 2
- Deactivate other pacing functions and tachyarrhythmia monitoring and therapies to avoid delivery of unwarranted therapies 2
- Re-programme the device immediately after the MRI examination 2
Importance of Recent Evidence
The most recent guidelines and studies, such as those from 2015 1, emphasize the importance of considering the specific type of ILR and adhering to conditions for safe MRI scanning. By following these guidelines and considering the latest evidence, patients with ILRs can undergo MRI scans with minimal risk, improving their diagnostic and treatment outcomes.
From the Research
MRI Compatibility with Implantable Loop Recorders (ILRs)
- Patients with ILRs can undergo MRI scans, but precautions should be taken to avoid potential interactions 3, 4, 5.
- Studies have shown that MRI scanning of ILR patients can be performed without harm to the patient or permanent damage to the ILR 3, 5.
- However, artifacts mimicking arrhythmias are common and must be excluded to avoid mistakenly attributing symptoms to the artifacts produced from MRI exposure 3, 5.
Safety Precautions
- The ILR memory should be cleared before MRI, and no changes should be made to programmed settings 3, 5.
- Device interrogation should take place immediately after the scan to verify the integrity of the signal and time date stamp 3.
- Patients should be surveyed for device movement, heating, and cardiopulmonary symptoms after their MRI 3, 5.
Feasibility of MRI in ILR Patients
- MRI is feasible in patients with ILRs, and with appropriate precautions, it can be performed without immediate morbidity or mortality 4.
- Local follow-up data has shown no device malfunction or adverse effects in patients with ILRs who underwent MRI 4.
- However, electromagnetic interference from MRI can potentially cause irreversible errors in ILR function, and physicians should be aware of possible malfunctioning of these devices 6.