Experiences of magnetic resonance imaging scanning in patients with pacemakers or implantable cardioverter-defibrillators
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Background/Aims: Despite the U.S. Food and Drug Adminstration approving a magnetic resonance imaging (MRI)-conditional pacemaker system in 2011, many physicians remain reluctant to perform MRI scanning in patients with cardiac implantable electronic devices. Herein, we aimed to evaluate the real-world safety of MRI in these patients. Methods: This single-center retrospective study examined the interrogation data and outcomes of patients with pacemakers or implantable cardioverter defibrillators who underwent MRI. MRI interrogation data were collected pre- and post-MRI and after 1 month of follow-up; these included the lead impedance, measured P- and R-wave amplitudes, and capture threshold. We compared these results between the magnetic resonance (MR)-conditional and conventional groups. Results: From September 2013 to December 2015, 35 patients with cardiac implantable electronic devices underwent 43 MRI scans, with a mean follow-up of 5 months. Among these 35 patients, 14 (40%) had MR-conditional devices and 21 (60%) had conventional devices. Seven patients had high voltage devices, which were all the conventional type. There were no adverse events associated with MRI during the follow-up period, and there were no significant differences in the interrogation data changes between the conventional and MR-conditional groups. Conclusions: This single-center retrospective study found that MRI can be performed safely in patients with pacemakers or implantable cardioverter defibrillators, regardless of the MRI support, as long as appropriate precautions are taken.
Abstract
Background/Aims: Despite the U.S. Food and Drug Adminstration approving a magnetic resonance imaging (MRI)-conditional pacemaker system in 2011, many physicians remain reluctant to perform MRI scanning in patients with cardiac implantable electronic devices. Herein, we aimed to evaluate the real-world safety of MRI in these patients. Methods: This single-center retrospective study examined the interrogation data and outcomes of patients with pacemakers or implantable cardioverter defibrillators who underwent MRI. MRI interrogation data were collected pre- and post-MRI and after 1 month of follow-up; these included the lead impedance, measured P- and R-wave amplitudes, and capture threshold. We compared these results between the magnetic resonance (MR)-conditional and conventional groups. Results: From September 2013 to December 2015, 35 patients with cardiac implantable electronic devices underwent 43 MRI scans, with a mean follow-up of 5 months. Among these 35 patients, 14 (40%) had MR-conditional devices and 21 (60%) had conventional devices. Seven patients had high voltage devices, which were all the conventional type. There were no adverse events associated with MRI during the follow-up period, and there were no significant differences in the interrogation data changes between the conventional and MR-conditional groups. Conclusions: This single-center retrospective study found that MRI can be performed safely in patients with pacemakers or implantable cardioverter defibrillators, regardless of the MRI support, as long as appropriate precautions are taken.
참고문헌 (26)
- Niehaus M, "Electromagnetic interference in patients with implanted pacemakers or cardioverter-defibrillators", Heart, 86, pp.246~248 (2001)
- Quint DJ, "Indications for emergent MRI of the central nervous system", JAMA, 283, pp.853~855 (2000)
- Kalin R, "Current clinical issues for MRI scanning of pacemaker and defibrillator patients", Pacing Clin Electrophysiol, 28, pp.326~328 (2005)
- Hayes DL, "Effect of 1.5 tesla nuclear magnetic resonance imaging scanner on implanted permanent pacemakers", J Am Coll Cardiol, 10, pp.782~786 (1987)
- Shellock FG, "Cardiac pacemakers, ICDs, and loop recorder: evaluation of translational attraction using conventional (“long-bore”) and “short-bore” 1.5- and 3.0-Tesla MR systems", J Cardiovasc Magn Reson, 5, pp.387~397 (2003)
- Luechinger R, "In vivo heating of pacemaker leads during magnetic resonance imaging", Eur Heart J, 26, pp.376~383 (2005)
- Mollerus M, "Ectopy in patients with permanent pacemakers and implantable cardioverter-defibrillators undergoing an MRI scan", Pacing Clin Electrophysiol, 32, pp.772~778 (2009)
- Gimbel JR, "Can patients with implantable pacemakers safely undergo magnetic resonance imaging?", J Am Coll Cardiol, 43, pp.1325~1327 (2004)
- Martin ET, "Magnetic resonance imaging and cardiac pacemaker safety at 1.5-Tesla", J Am Coll Cardiol, 43, pp.1315~1324 (2004)
- Roguin A, "Magnetic resonance imaging in patients with implantable cardioverter-defibrillators and pacemakers", J Am Coll Cardiol, 54, pp.556~557 (2009)
- European Society of Cardiology, "2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)", Europace, 15, pp.1070~1118 (2013)
- Verma A, "Canadian Heart Rhythm Society and Canadian Association of Radiologists consensus statement on magnetic resonance imaging with cardiac implantable electronic devices", Can J Cardiol, 30, pp.1131~1141 (2014)
- Maglia G, "Assessing access to MRI of patients with magnetic resonance-conditional pacemaker and implantable cardioverter defibrillator systems : the Really ProMRI study design", J Cardiovasc Med(Hagerstown), 16, pp.715~720 (2015)
- Nazarian S, "Clinical utility and safety of a protocol for noncardiac and cardiac magnetic resonance imaging of patients with permanent pacemakers and implantable-cardioverter defibrillators at 1.5 tesla", Circulation, 114, pp.1277~1284 (2006)
- Sommer T, "Strategy for safe performance of extrathoracic magnetic resonance imaging at 1.5 tesla in the presence of cardiac pacemakers in non-pacemaker-dependent patients: a prospective study with 115 examinations", Circulation, 114, pp.1285~1292 (2006)
- Levine GN, "Safety of magnetic resonance imaging in patients with cardiovascular devices : an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention : endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance", Circulation, 116, pp.2878~2891 (2007)
- Burke PT, "A protocol for patients with cardiovascular implantable devices undergoing magnetic resonance imaging(MRI) : should defibrillation threshold testing be performed post-(MRI)", J Interv Card Electrophysiol, 28, pp.59~66 (2010)
- Forleo GB, "Safety and efficacy of a new magnetic resonance imaging-compatible pacing system: early results of a prospective comparison with conventional dual-chamber implant outcomes", Heart Rhythm, 7, pp.750~754 (2010)
- Wilkoff BL, "Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environment", Heart Rhythm, 8, pp.65~73 (2011)
- Jung W, "Safe magnetic resonance image scanning of the pacemaker patient : current technologies and future directions", Europace, 14, pp.631~637 (2012)
- Gold MR, "Full-body MRI in patients with an implantable cardioverter-defibrillator : primary results of a randomized study", J Am Coll Cardiol, 65, pp.2581~2588 (2015)
- The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC), "2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy", Rev Esp Cardiol(Engl Ed), 67, pp.58~ (2014)
- Roguin A, "Modern pacemaker and implantable cardioverter", defibrillator systems can be magnetic resonance imaging safe: in vitro and in vivo assessment of safety and function at 1.5 T, 2004, pp.110, 475~482
- Nazarian S, "A prospective evaluation of a protocol for magnetic resonance imaging of patients with implanted cardiac devices", Ann Intern Med, 155, pp.415~424 (2011)
- Russo RJ, "Assessing the risks associated with MRI in patients with a pacemaker or defibrillator", N Engl J Med, 376, pp.755~764 (2017)
- You Mi Hwang, "Cardiac Implantable Electronic Device Safety during Magnetic Resonance Imaging", Korean Circulation Journal, 46(6), pp.804~810 (2016), 대한심장학회