Safety of magnetic resonance in patients with pacemakers
DOI:
https://doi.org/10.29166/ciencias_medicas.v44i1.1971Keywords:
Magnetic resonance, ionizing radiation, syncope, safety, cardiac arrhythmiaAbstract
Background: Currently, Magnetic Resonance (MR) studies are performed very frequently because they do not use ionizing radiation and are not invasive. However, there is confusion in medical staff about how to proceed when this study is required in people with cardiovascular diseases who carry prostheses or devices (pacemakers, defibrillators and / or resynchronizers) with ferromagnetic components that represent a risk to the patient.
Case presentation: A 47-year-old woman with a clinic compatible with neurally mediated syncope, in the last two years.He had a positive tilt table test for vasovagal syncope with cardioinhibitory response (asystole for 20 seconds). He received non-pharmacological and pharmacological treatment, without the disappearance of the syncopal episodes, so that a bicameral pacemaker was implanted, with an algorithm for heart rate drop. Three years after the implant, he presented a vascular brain event, so a brain MRI was performed. Fortunately, the pacemaker and implanted cables conditionally supported this study without alterations in the pacemaker, programming, or cables and without affecting the patient.
Conclusion: This case adds evidence to the literature on the safety of the MRI study in patients with ferromagnetic devices such as the bicameral pacemaker. Although more evidence is needed, pacemakers or other devices compatible with MRI studies should be implanted, especially in populations with a higher risk of requiring them at some time.
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