Magnetic resonance imaging in patients with cardiac implanted electronic devices: impact of an automatic MRI programming function on patient wait times and outcomes

Abstract Background/Introduction Performing magnetic resonance (MRI) scans in patients with cardiac implanted electronic devices (CIEDs) is logistically challenging as pre- and post- MRI device programming to ensure an ‘MRI safe’ mode (usually ‘DOO’ or ‘VOO’) must coincide with scan timing. Automatic MRI mode (hereafter, "aMRI") is a feature available on certain devices which can be switched on pre-MRI and lasts 2 weeks. Once enabled, the device will automatically switch into an MRI safe mode when the patient enters an MRI scanning field, returning to original programming once out of the field, thus minimising the time the patient spends in MRI safe mode and streamlining the logistics of arranging the scan. The post MRI check is done remotely via home monitoring in the majority of cases thus negating the need for a second face-to-face physiologist review. Purpose To review real-world experience of using an automatic MRI detection mode in CIED patients and to compare waiting times and safety profile compared to those without this feature. Methods Single-centre retrospective observational study from May 2019 – Sept 2024. Results Over a 5-year period, MRI scans were performed in 558 patients with CIEDs, including 337 (60.3%) with the aMRI feature and 222 (39.7%) without. For outpatients with aMRI, waiting times were significantly lower for than in patients without this function, with median wait times for routine outpatient scans 53 versus 89 days (p value < 0.0001) and urgent outpatient scans 25 versus 48 days (p value 0.00021). No major device or scan related complications were seen across all scan types in either cohort. Conclusion In this retrospective observational study of CIED patients, an automatic MRI mode was safe. Patients with this feature had a shorter wait time for outpatient MRI scan, likely due to improved logistics and workflow.