Magnetic resonance imaging in a patient with an implantable cardiac defibrillator

Abstract

A 58-year-old man, in whom an implantable cardiac defibrillator (ICD) had been implanted for Brugada syndrome, suffered rapidly progressive general paralysis. Various diagnostic imaging techniques were performed, but the cause could not be determined. Magnetic resonance imaging (MRI) scanning was performed. A 1.5-Tesla MRI system was used, and the ICD was programmed to ODO mode and all tachycardia detection was turned off. MRI was performed safely under electrocardiogram and pulse oximeter monitoring, and appropriate precautions were taken in preparation for an emergency. ICD parameters did not change in post-imaging investigations. MRI revealed an apparent tumor in the patient's medulla and upper cervical spinal cord, which was diagnosed as high-grade astrocytoma. When performing MRI procedures in patients with an ICD under urgent conditions, it is necessary to have complete knowledge of the procedure and to make careful preparations.