MRI for patients with cardiac implantable electrical devices.

MRI has become an invaluable tool in the evaluation of soft tissue and bony abnormalities. The presence of a cardiac implantable electrical device (CIED) may complicate matters, however, because these devices are considered a contraindication to MRI scanning. When MRI is performed in patients with a CIED, risks include reed switch activation in older devices, lead heating, system malfunction, and significant radiofrequency noise resulting in inappropriate inhibition of demand pacing, tachycardia therapies, or programming changes. This report reviews indications and risk-benefit evaluation of MRI in patients with CIED and provides a clinical algorithm for performing MRI in patients with implanted devices.