6
Management of Patients with a CIED
Referred for MRI
Table 5. Recommendations and Protocol for the Management
of Patients with an MR Conditional Device
Undergoing MRI
Recommendations COR LOE
MR conditional devices should be considered MR conditional
only when the product labeling is adhered to, which includes
programming the appropriate "MR mode" and scanning with
the prerequisites specified for the device.
I A
MR imaging in a patient with an MR conditional system
should always be performed in the context of a rigorously
applied standardized institutional workflow, following the
appropriate conditions of use.
I B-R
It is recommended for patients with an MR conditional system
that personnel with the skill to perform advanced cardiac
life support, including expertise in the performance of CPR,
arrhythmia recognition, defibrillation, and transcutaneous
pacing, be in attendance with the patient for the duration of
time the patient's device is reprogrammed, until assessed and
declared stable to return to unmonitored status.
I B-R
It is recommended for patients with an MR conditional system
that ECG and pulse oximetry monitoring be continued until
baseline, or until other clinically appropriate CIED settings are
restored.
I A
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
It is recommended for patients with an MR conditional system
that personnel with the skill to program the CIED be available
as defined by the institutional protocol.
I C-EO
It is reasonable to perform an MR scan on a patient with an MR
conditional system implanted more recently than the exempt
period for conditionality of the system, based on assessment of
risk and benefit for that patient.
IIa C-EO
