Allegheny General Hospital Study Demonstrates Safety, Effectiveness of MRI for Patients with Implantable Cardiac Devices

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The findings of a major study led by cardiovascular imaging specialists at Allegheny General Hospital (AGH), part of the Allegheny Health Network (AHN), suggest that magnetic resonance imaging is a safe and effective diagnostic procedure for patients with implantable cardiac devices. The research, believed to be the first ever focused solely on the value of MRI in this patient population, is being presented today at the annual Society of Cardiovascular MRI Scientific Sessions meeting in Los Angeles.

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This ongoing study has shown that using MRI on patients with implanted pacemakers and defibrillators has added substantial clinical value to patient diagnosis and subsequent patient management, justifying the risk of the procedure.

The findings of a major study led by cardiovascular imaging specialists at Allegheny General Hospital (AGH), part of the Allegheny Health Network (AHN), suggest that magnetic resonance imaging is a safe and effective diagnostic procedure for patients with implantable cardiac devices. The research, believed to be the first ever focused solely on the value of MRI in this patient population, is being presented today at the annual Society of Cardiovascular MRI Scientific Sessions meeting in Los Angeles.

“Having already established the safety of MRI for patients with these devices when performed at cardiac MRI centers with advanced capabilities, it was important to determine if significant life-saving or life-changing diagnoses could also be made based on the results of the MRI,” said Robert Biederman, MD, Medical Director of the Cardiovascular MRI Center at AGH’s Cardiovascular Institute and one of the lead researchers on the study. “This ongoing study has shown that using MRI on patients with implanted pacemakers and defibrillators has added substantial clinical value to patient diagnosis and subsequent patient management, justifying the risk of the procedure.

“Now that we have been able to minimize the risks of MRI to patients with these implanted devices, it was crucial to prove the value of using what has really become the imaging tool of choice for countless clinical diagnoses ,” added Dr. Biederman, who served as moderator for the SCMR’s opening session this week.

Over the last several years, AGH specialists evaluated 157 patients. That included 114 neurology/neurosurgery cases, 36 cardiovascular cases and seven musculoskeletal cases. For 88 percent of the neurology/neurosurgery cases, the MRI scan added value to the final diagnoses – with 18 percent of those cases seeing a change to the original diagnoses thanks to the use of MRI. And 92 percent of the cardiac cases saw a benefit from the use of MRI, while 100 percent of the musculoskeletal cases realized a benefit from using MRI. Additionally, Dr. Biederman reported, there were no adverse clinical events associated with it for any of the patients studied.

Approximately three million Americans currently have an implanted cardiac device and hundreds of thousands more receive them each year. It is estimated that as many as three-quarters of those who have a pacemaker or ICD will require an MRI at some point in their lifetimes.

“MRI is simply too important a diagnostic tool not to be able to have it in our arsenal to evaluate and help determine the best treatment for patients who have an implanted device,” said Dr. Biederman. “Once the safety of using it had been established, there was still some question about its ultimate value. We believe the results of this study provide a clear and resounding answer to that question.”

Under Dr. Biederman’s direction, patients with implanted cardiac devices who are referred for MRI at the hospital undergo an extensive evaluation of their cardiovascular health and level of device dependence.

Once a patient is cleared to undergo MRI, Dr. Biederman and his team perform a baseline device interrogation and then convert the pacemaker and/or defibrillator to a safer mode of operation for the length of the test. If patients are determined to be non-pacemaker dependent under baseline conditions, the device may be turned off completely while the imaging takes place, further reducing but not eliminating risk. Additionally, manipulations of the MRI environment to minimize likelihood of heating, induction of radio-frequency energy and triggering of certain potentially lethal rhythms are performed.

During the procedure, a patient’s heart rhythm is monitored in real-time in the MRI suite and the entire process is closely supervised by Dr. Biederman, Dr. Moneal Shah, a cardiovascular physicist and the Cardiovascular MRI Center’s team of nurses and technologists. Once the MRI is completed, the implanted device is reprogrammed to its original settings.

Those who would like more information about AGH’s pacemaker/MRI program can call the Cardiovascular MRI Laboratory at 412-359-8009.

Allegheny Health Network is rated the #1 health system in western Pennsylvania and among the top 5 percent nationally for cardiac care, interventional heart care and heart attack treatment according to Comparion® Medical Analytics, 2016 National Quality Rating Database.

About Allegheny Health Network
Allegheny Health Network, part of Highmark Health, is an integrated healthcare delivery system serving the Western Pennsylvania region. The Network is comprised of eight hospitals, including its flagship academic medical center Allegheny General Hospital, Allegheny Valley Hospital, Canonsburg Hospital, Forbes Hospital, Jefferson Hospital, Saint Vincent Hospital, Westfield Memorial Hospital and West Penn Hospital; a research institute; Health + Wellness Pavilions; an employed physician organization, home and community based health services and a group purchasing organization. The Network employs approximately 17,500 people and has more than 2,100 physicians on its medical staff. The Network also serves as a clinical campus for Temple University School of Medicine, Drexel University College of Medicine and the Lake Erie College of Osteopathic Medicine.

About the AGH Cardiovascular Institute
Allegheny General Hospital, the quaternary flagship of Allegheny Health Network’s Cardiovascular Institute, offers comprehensive, state-of-the-art care for the complete spectrum of cardiovascular disease. The hospital’s nationally recognized medical staff includes specialists in general and interventional cardiology, electrophysiology, leading-edge diagnostic cardiology – including cardiovascular MRI, CT and 3-D echocardiography – women’s heart care, heart failure and pulmonary hypertension, heart transplantation and mechanical circulatory support, vascular surgery and wound care, thoracic surgery, heart valve disease and coronary artery bypass surgery. AGH is recognized by leading healthcare industry analyst Comparion as western Pennsylvania’s top hospital in quality and safety for overall cardiovascular care and complex heart surgery.

AGH’s broad scope of advanced capabilities in the treatment of heart failure offers patients access to cutting-edge investigational therapies being explored in clinical trials, such as new medicines and implantable devices designed to more effectively monitor disease progression and treat conditions before they require hospitalization. The hospital was recently the first in western Pennsylvania to use the latest-generation total artificial heart to provide a bridge to transplantation for patients with end-stage heart failure. It also has become one of just a few national referral centers for advanced treatment of pulmonary hypertension. AGH’s heart transplant program is lauded by both Comparion and the National Scientific Registry of Transplant Recipients as having the best patient outcomes of any program in the region.

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Doug Braunsdorf
Allegheny Health Network
+1 412-522-7112
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