2021 Update on Safety of Magnetic Resonance Imaging: Joint Statement From Canadian Cardiovascular Society/Canadian Society for Cardiovascular Magnetic Resonance/Canadian Heart Rhythm Society

Magnetic resonance imaging (MRI) is often considered the gold-standard test for characterizing cardiac as well noncardiac structure and function. However, many patients with implantable electronic devices (CIEDs) and/or severe renal dysfunction are unable to undergo this because of safety concerns. In past 10 years, newer-generation CIEDs gadolinium-based contrast agents (GBCAs) coordinated care between heart rhythm device teams have mitigated risk improved access MRI at hospitals. The purpose statement review published data on in conditional nonconditional addition patient risks from older newer GBCAs. This was developed through multidisciplinary collaboration pan-Canadian experts after a relevant independent literature search by Canadian Agency Drugs Technologies Health. All recommendations align Grading Recommendations Assessment, Development Evaluation (GRADE) system. Key include: (1) development standardized protocols CIED undergoing MRI; (2) pacemakers pacemaker dependency should be programmed asynchronous mode those transvenous defibrillators tachycardia therapies turned off during scan; (3) macrocyclic or linear GBCAs used preference their better profile higher nephrogenic systemic fibrosis.