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Magnetic Resonance Imaging with Implantable Cardioverter Defibrillators (ProMRI ICD in the U.S.)indications and technology update;Objectives;Permanent Pacemaker (PPM);Permanent Pacemakers;Implantable Cardioverter Defibrillator (ICD);ICDs;THE NEED FOR MRI SCANNING;MRI NEED IN THE ELDERLY; 1 in 3 adults age 65 or older fall annually1 30% lead to injuries like hip fractures and head trauma Atrial fibrillation is implicated in 25% of all strokes in the U.S.2 Incidence of atrial fibrillation in pacemaker patients is 11 - 13% per year3 While CT is often used for stroke imaging, MRI is more informative and is the diagnostic tool of choice for stroke diagnosis based on American College of Radiology guidelines ;50-75% of patients with a cardiac rhythm device will need access to MR scanning procedures.1 ~ 200,000 new patients each year indicated for MRI ;~ 20% of pacemaker patients need an MRI within 2 years after implantation1;Recommendations for MRI as preferred imaging for: ;IONIZING RADIATION CONCERNS;Ventricular function and mass Myocardial Viability Structural Heart Disease Valvular Heart Disease CRT Applications EP Applications ;MRI to guide ablation therapy for AF may stratify responders and non-responders to ablation therapy ;;MRI COMPLICATIONS;MRI COMPLICATIONS: DEATHS;;Disposition: Settlement Date: 12/28/1996 Type of Case: Medical Malpractice Allegation(s): MRI Performed on Patient with Pacemaker Result: $250,000 Case Name: John Doe v. Dr Roe and Hospital (Confidential);Device: St. Jude Medical Zephry XR SR Pacemaker Problem: “Attempts to interrogate device with two separate programmers resulted in error messages. No telemetry.” Cause: “The pulse generator was exposed to magnetic resonance imaging in early 2009. Final analysis found the pulse generator was in back-up mode due to multiple flipped bits.” Outcome: “The device was explanted and replaced.” ;Device: Boston Scientific Vitality DS ICD Problem: “Boston Scientific received information that t