Feasibility, safety, and potential demand of emergent brain magnetic resonance imaging of patients with cardiac implantable electronic devices

BACKGROUND: The feasibility, safety, and potential demand of emergent magnetic resonance imaging (MRI) of patients with a cardiac implantable electronic device (CIED) in emergency situations are unknown. METHODS: We retrospectively compared emergent and scheduled MRI orders for patients with CIEDs at Kameda General Hospital, a tertiary hospital in Japan, from October 2012 to September 2016. RESULTS: We identified 11 emergent MRI orders via the emergency room and 38 scheduled MRI orders. Although the baseline characteristics were similar between the two groups, brain scanning was predominant in emergent scanning (p=0.002). The reasons for MRI and physicians who ordered it were also significantly different between the two groups (p<0.001, p=0.03, respectively). Among the emergent orders via the emergency room, 10 out of 11 were brain scans. Nine out of 10 patients underwent successful emergent brain MRI. The time from arrival at the emergency room to MRI was 144±29 min, and the time from the MRI order made by the cardiologist to its actual performance was 60±10 min. Four out of 9 patients had a diagnosis of acute stroke confirmed by emergent MRI, and two had emergent thrombolysis with a complete neurological recovery. All emergent scanning was conducted safely with no complications. CONCLUSIONS: Our study found the potential demand of brain MRI of patients with CIEDs in emergency situations compared with scheduled scanning, which was shown to be feasible and safe for the diagnosis and treatment of an acute stroke.