Utilization and programming of an automatic MRI recognition feature for cardiac rhythm management devices

Abstract

Background: Cardiac implantable electronic devices (CIED)—ie, pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices—have recently been designed to allow for patients to safely undergo magnetic resonance imaging (MRI) when specific programming is implemented. MRI AutoDetect is a feature that automatically switches CIED’s programming into and out of an MR safe mode when exposed to an MRI environment. Objective: The purpose was to analyze de-identified daily remote transmission data to characterize the utilization of the MRI AutoDetect feature. Methods: Home Monitoring transmission data collected from MRI AutoDetect–capable devices were retrospectively analyzed to determine the workflow and usage in patients experiencing an MRI using the MRI AutoDetect feature. Results: Among 48,756 capable systems, 2197 devices underwent an MRI using the MRI AutoDetect feature. In these 2197 devices, the MRI AutoDetect feature was used a total of 2806 times with an average MRI exposure of 40.83 minutes. The majority (88.9%) of MRI exposures occurred on the same day as the MRI AutoDetect programming. A same day post-MRI exposure follow-up device interrogation was performed 8.6% of the time. A device-related complaint occurred within 30 days of the MRI exposure in 0.25% of MRI exposures using MRI AutoDetect but with no adverse clinical outcome. Conclusion: As a result of automation in device programming, the MRI AutoDetect feature eliminated post-MRI device reprogramming in 91.4% of MRI exposures and, while less frequent, allowed for pre-MRI interrogations prior to the day of the MRI exposure—reducing resource utilization and creating workflow flexibility.

Keywords

• Automation
• Defibrillator
• Device programming
• Magnetic resonance imaging
• MRI-conditional
• MRI detection