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Current guidelines for MRI safety in patients with cardiovascular implantable electronic devices

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doi: 10.1097/01.NURSE.0000654516.95238.d4
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INSTRUCTIONS Current guidelines for MRI safety in patients with cardiovascular implantable electronic devices


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Current guidelines for MRI safety in patients with cardiovascular implantable electronic devices

GENERAL PURPOSE: To examine the risks of MRI technology for patients with CIEDs. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Explain the basics of MRI technology. 2. Identify the safety classifications that apply to MRI and CIEDs. 3. List the precautions for patients with CIEDs who are undergoing MRI.

  1. Which of the following technologies senses and terminates potentially lethal dysrhythmias, such as ventricular tachycardia or ventricular fibrillation?
    1. PM
    2. CRT
    3. ICD
  2. CRT is used to treat patients who have
    1. right atrial diastolic dysfunction.
    2. left ventricular systolic dysfunction.
    3. left atrial systolic dysfunction.
  3. The component of a CIED where the leads attach to the pulse generator is the
    1. header.
    2. capacitor.
    3. electrodes.
  4. The pulse generator
    1. contains the leads that deliver electrical impulses to the heart.
    2. is usually implanted subcutaneously in the right upper chest area.
    3. contains a battery encased in a titanium metal body.
  5. Which element of MRI serves to orient protons?
    1. the static magnetic field
    2. the magnetic field gradients
    3. the RF pulsed waves
  6. Which element of MRI represents the energy source that generates an image?
    1. the magnetic field gradients
    2. the static magnetic field
    3. the RF pulsed waves
  7. Fractured or abandoned leads may be prone to
    1. inappropriate pacing inhibition.
    2. overheating.
    3. reactivation.
  8. Criteria for CIEDs that have been designated MR conditional include a
    1. magnetic field strength of 1.5 T.
    2. specific absorption rate of 1.0 W/kg.
    3. maximum magnetic field slew rate of 100 T/m/s.
  9. Which of the following may result in a non-MR conditional CIED designation?
    1. an inactive noncardiac device in the MRI field
    2. transvenous leads
    3. fractured leads
  10. An MR unsafe designation refers to ferromagnetic items within the MRI field, such as
    1. coins.
    2. contact lenses.
    3. dental implants.
  11. MRI utilization policies and procedures can reduce the potential for adverse reactions by
    1. enhancing RF transmission.
    2. increasing gradient slew rates.
    3. incorporating lower static magnetic fields.
  12. Approximately what percentage of patients with a CIED will need MRI in their lifetime?
    1. 50% to 75%
    2. 30% to 40%
    3. 10% to 20%
  13. Safety checklists for patients with CIEDs undergoing MRI include
    1. relevant characteristics of the patient.
    2. pre- and post-MRI device parameters.
    3. emergency protocols for adverse events.
  14. In the event of CIED inhibition, scans must be aborted in patients who are dependent on pacemakers or who experience
    1. clinically stable sinus bradycardia.
    2. atrial fibrillation.
    3. ventricular dysrhythmias.
  15. For healthcare professionals with CIEDs, HRS recommends
    1. not caring for patients after they have undergone an MRI.
    2. frequent cardiovascular status checks.
    3. posting clear signage around the MRI suite about safe environmental boundaries.
  16. CRT is also called biventricular
    1. pacing.
    2. assist device.
    3. support.
  17. A recommended option for patients with a history of claustrophobia is a
    1. constant visual contact with the technician.
    2. large-bore or open MRI scanner.
    3. technician remaining in the scanner room.
  18. If the programmed CIED settings have been significantly altered from pre-MRI settings, patients should follow up with their provider within
    1. 24 hours.
    2. 3 days.
    3. 1 week.
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