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[心脏起搏器和植入式心脏复律除颤器在磁共振成像中的安全性。1.5特斯拉时的综合功能评估]

[Safety of cardiac pacemakers and implantable cardioverter-defibrillators in magnetic resonance imaging. Assessment of the aggregate function at 1.5 tesla].

作者信息

Nordbeck P, Bauer W R

机构信息

Medizinische Klinik und Poliklinik I, Universität Würzburg.

出版信息

Dtsch Med Wochenschr. 2008 Mar;133(13):624-8. doi: 10.1055/s-2008-1067294.

Abstract

BACKGROUND AND OBJECTIVE

Magnetic resonance imaging (MRI) is increasingly used in patients, but it is contraindicated in those with cardiac pacemakers (CP) or implantable cardioverter defibrillators (ICD). This study examined circumstances in which potentially life-threatening arrhythmias may be triggered in patients with CP undergoing MRI and whether these problems can be avoided by reprogramming of these devices.

METHODS

Eight CP and seven ICDs were investigated in a phantom at 1.5 tesla (experimental and imaging sequences).

RESULTS

A decrease in battery voltage was found in four CP after MRI (indication for elective replacement). Additionally, three showed changes in programming (resets). Analogous changes did not appear in the tested ICDs, but periods of tachycardia were recorded in all types of devices during MRI depending on the pulse sequence employed.

CONCLUSION

MRI-related electromagnetic fields as used in routine MRI can induce severe pacemaker device malfunctions. Device programming approaches are unreliable for prevention of patient hazards, as programming changes or resets are one of the primary malfunctions during MRI.

摘要

背景与目的

磁共振成像(MRI)在患者中的应用日益广泛,但对于有心脏起搏器(CP)或植入式心脏复律除颤器(ICD)的患者是禁忌的。本研究调查了接受MRI检查的CP患者中可能引发危及生命的心律失常的情况,以及通过重新编程这些设备是否可以避免这些问题。

方法

在1.5特斯拉的模型中对8个CP和7个ICD进行了研究(实验和成像序列)。

结果

MRI检查后,4个CP的电池电压下降(提示择期更换)。此外,3个出现了编程变化(重置)。在测试的ICD中未出现类似变化,但在MRI期间,根据所采用的脉冲序列,所有类型的设备均记录到心动过速期。

结论

常规MRI中使用的与MRI相关的电磁场可诱发严重的起搏器设备故障。由于编程变化或重置是MRI期间的主要故障之一,因此设备编程方法对于预防患者危险并不可靠。

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