Table 7.

A summary of MR safety studies in pediatric patients with a CIED.

Pediatric-specific considerations	Citations	Summary of evidence
Patients of pediatric size require a pre-imaging assessment to ensure that image artifact is not likely to obscure diagnostic information.	[158], [159], [160], [161], [162], [163]	Strong evidence that CIEDs image artifact can prevent diagnostic quality imaging. Limited evidence suggests the problem is more prevalent in children.
A risk-benefit discussion, preferably with documented informed consent, should be obtained for imaging of non-MR-conditional systems or those with retained leads.	[42], [137], [138], [139], [140], [141]	With fewer than 100 pediatric patients in the literature, high-volume pediatric centers continue to obtain informed consent for non-MR-conditional systems
Sedation and general anesthesia increase the risks of undetected lead heating and should be avoided in children when possible	[41], [42]	Individual patients have reported discomfort during MRI scans, without objective evidence for harm.
Epicardial leads that cannot be assessed with an active pulse generator should be evaluated as if they were fractured.	[40], [43]	Lead fractures are not always obvious on chest radiography and fractured leads have been associated with a higher risk of tip heating.