8
Management of Patients with a CIED
Referred for MRI
For patients with an MR nonconditional CIED who are
pacing-dependent (PM or ICD), it is recommended that:
a. Personnel with the skill to program the CIED be in
attendance during MR scanning.
b. A physician with the ability to establish temporary
transvenous pacing be immediately available on the premises
of the imaging facility.
c. A physician with the ability to direct CIED programming be
immediately available on the premises of the imaging facility.
I B-NR
For patients with an MR nonconditional CIED who are not
pacing-dependent, it is recommended that:
a. Personnel with the skill to program the CIED be available on
the premises of the imaging facility
b. A physician with the ability to direct CIED programming be
available on the premises of the imaging facility
I B-NR
It is recommended that for the patient with an MR
nonconditional CIED who is pacing-dependent to program
their device to an asynchronous pacing mode with deactivation
of advanced or adaptive features during the MRI examination,
and the pacing rate should be selected to avoid competitive
pacing.
I B-NR
All tachyarrhythmia detections for patients with an ICD
should be disabled prior to MRI.
I B-NR
e MR-responsible physician who is accountable for
overseeing the safety of the MRI environment, including the
administration of any medication and/or contrast agents (if
applicable) should be made aware of the presence of a patient
with an MR nonconditional CIED.
I C-EO
It is recommended that ECG and pulse oximetry monitoring
be continued until baseline or until other clinically appropriate
CIED settings are restored for patients with an MR
nonconditional CIED.
I C-EO
All resuscitative efforts and emergency treatments that involve
the use of a defibrillator/monitor, device programming system,
or any other MRI-unsafe equipment should be performed aer
moving the patient outside of Zone 4.
I C-EO
Table 7. Recommendations for the Management of Patients
with an MR Nonconditional CIED Who Are to Have
an MRI Scan (cont'd)
Recommendations COR LOE
