Feasibility and image quality of myocardial perfusion imaging by CMR in patients with conditional and non-conditional cardiac devices

Abstract Purpose First, to determine image quality using different cardiovascular magnetic resonance (CMR) perfusion protocols in patients with all available active device types a real-world setting, including non-conditional devices. Second, demonstrate feasibility of high-quality imaging spoiled gradient echo (sGE) for non-invasive stress-testing. Methods From August 2020 March 2022, N=222 cardiac implantable electronic devices (CIED) were scanned on 1.5-T MR scanner (Philips Ingenia and Ambition). Our CMR scanning protocol was tailored the clinical indication, whenever myocardial possible, both conventional steady-state-free-precession (SSFP)-based modified sGE-perfusion applied. Such performed N=119 (70% men) exclusively left-sided (pacemaker (PM), n=45; cardioverter-defibrillator (ICD), n=46; subcutaneous ICD (S-ICD), n=15 resynchronization therapy-pacemaker (CRT-P, n=5) or -defibrillator (CRT-D, n=8) percentage 10% For assessment quality, semi-quantitative 4-point grading scale used based standard 16-segment model. Results A total N=33 stress-tests either regadenosone, adenosine dobutamine N=86 rest performed. Asynchronous pacing required 34% due heart rate <40bpm. Device interrogation before after showed no significant changes. Image substantially better sGE-based compared SSFP-based ICD, CRT-D S-ICD (p<0.001). In PM/ CRT-P neither significantly impaired SSFP- nor protocols. Most artefacts located primarily anterior segments (1, 7, 13) transvenous implanted lateral SICD-patients. relationship between extent parameters LVEDV (p=0.03), LVESV (p=0.005) (p=0.029) SSFP-perfusion found PM/CRT-P. contrast, there correlation CMR-parameters ICD/ CRT-D. S-ICD-patients, an inverse artefact age (p=0.006), BMI (p=0.001) sGE-perfusion. Conclusion Myocardial by is safe feasible high image-quality kinds CIEDs – MR-conditional as well When performing CMR-based ICD/CRT-D/S-ICD, perfusion-protocol should be preferred order achieve artefact-free interpretable images. Funding Acknowledgement Type funding sources: None.