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Evidence to support magnetic resonance conditional labelling of all pacemaker and defibrillator leads in patients with cardiac implantable electronic devices.
Bhuva, Anish N; Moralee, Russell; Brunker, Tamara; Lascelles, Karen; Cash, Lizette; Patel, Kush P; Lowe, Martin; Sekhri, Neha; Alpendurada, Francisco; Pennell, Dudley J; Schilling, Richard; Lambiase, Pier D; Chow, Anthony; Moon, James C; Litt, Harold; Baksi, A John; Manisty, Charlotte H.
Afiliación
  • Bhuva AN; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Moralee R; Institute for Cardiovascular Science, University College London, London, WC1E 6HX, UK.
  • Brunker T; Health Data Research UK, University College London, London, UK.
  • Lascelles K; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Cash L; Department of Radiology, Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Patel KP; Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, SW3 6NP, UK.
  • Lowe M; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Sekhri N; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Alpendurada F; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Pennell DJ; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Schilling R; Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, SW3 6NP, UK.
  • Lambiase PD; Cardiovascular Magnetic Resonance Unit, Royal Brompton & Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, SW3 6NP, UK.
  • Chow A; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Moon JC; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Litt H; Institute for Cardiovascular Science, University College London, London, WC1E 6HX, UK.
  • Baksi AJ; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
  • Manisty CH; Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, EC1A 7BE, UK.
Eur Heart J ; 43(26): 2469-2478, 2022 07 07.
Article en En | MEDLINE | ID: mdl-34435642
AIMS: Many cardiac pacemakers and defibrillators are not approved by regulators for magnetic resonance imaging (MRI). Even following generator exchange to an approved magnetic resonance (MR)-conditional model, many systems remain classified 'non-MR conditional' due to the leads. This classification makes patient access to MRI challenging, but there is no evidence of increased clinical risk. We compared the effect of MRI on non-MR conditional and MR-conditional pacemaker and defibrillator leads. METHODS AND RESULTS: Patients undergoing clinical 1.5T MRI with pacemakers and defibrillators in three centres over 5 years were included. Magnetic resonance imaging protocols were similar for MR-conditional and non-MR conditional systems. Devices were interrogated pre- and immediately post-scan, and at follow-up, and adverse clinical events recorded. Lead parameter changes peri-scan were stratified by MR-conditional labelling. A total of 1148 MRI examinations were performed in 970 patients (54% non-MR conditional systems, 39% defibrillators, 15% pacing-dependent) with 2268 leads. There were no lead-related adverse clinical events, and no clinically significant immediate or late lead parameter changes following MRI in either MR-conditional or non-MR conditional leads. Small reductions in atrial and right ventricular sensed amplitudes and impedances were similar between groups, with no difference in the proportion of leads with parameter changes greater than pre-defined thresholds (7.1%, 95% confidence interval: 6.1-8.3). CONCLUSIONS: There was no increased risk of MRI in patients with non-MR conditional pacemaker or defibrillator leads when following recommended protocols. Standardizing MR conditions for all leads would significantly improve access to MRI by enabling patients to be scanned in non-specialist centres, with no discernible incremental risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Marcapaso Artificial / Desfibriladores Implantables Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Eur Heart J Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Marcapaso Artificial / Desfibriladores Implantables Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Eur Heart J Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido