TOPLINE

Electrophysiology nurse practitioners (NPs) enabled safe MRI scans among patients with congenital heart disease and cardiac implantable electronic device (CIED), including those with abandoned leads and MRI-nonconditional devices, without any adverse outcomes.

METHODOLOGY

• Researchers conducted a single-center retrospective study of 27 pediatric and adult patients with congenital heart disease with CIEDs who underwent a total of 28 NP-led MRI scans between November 2022 and February 2025. Median patient age was 21.7 years.
• A certified electrophysiology NP determined the compatibility of CIEDs with MRI and the associated risks, as well as the programming changes required, if any, and the optimal modes for use during MRI; 21 patients had CHD at the time of MRI scan.
• The NP was present during the entire scan for patients with MRI-nonconditional CIEDs to monitor rhythms and to perform programming changes if required.
• A full interrogation was completed before and immediately after MRI; clinically significant lead parameter changes, arrhythmias, and patient-reported symptoms during MRI were assessed by the NPs and recorded.

TAKEAWAY

• Abandoned or fragmented epicardial leads were present in 25% of patients, and there were 18 MRI nonconditional devices.
• No patient had clinically significant changes in lead parameter, arrhythmias, or patient-reported symptoms during or immediately after MRI.
• The mean time spent by NPs for monitoring patients during MRI was 100 minutes; this did not include the time spent for preliminary assessment and risk determination.
• Although none of the patients required programming changes during MRI, the NP stayed throughout the scan for 22 (78%) scans for continuous monitoring.

IN PRACTICE

“Specialized EP [electrophysiology] NP-provided peri-MRI CIED management can be a successful physician-adjacent service,” the authors wrote.

SOURCE

The study was led by Brynn E. Dechert, MSN, CPNP, FHRS, Department of Pediatrics, University of Michigan, Congenital Heart Center, Ann Arbor, Michigan. It was published online on June 9, 2026, in Heart Rhythm O2.

LIMITATIONS

The development and use of the study protocol at a single center, the small and homogeneous sample size, and the retrospective design of the study may have limited the generalizability of the findings.

DISCLOSURES

No specific funding was received for the study from agencies in the public, commercial, or not-for-profit sectors. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.