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一种新型磁共振兼容起搏系统的安全性和有效性:与传统双腔植入物结果前瞻性比较的早期结果。

Safety and efficacy of a new magnetic resonance imaging-compatible pacing system: early results of a prospective comparison with conventional dual-chamber implant outcomes.

机构信息

Department of Internal Medicine, Division of Cardiology, University of Rome Tor Vergata, Rome, Italy.

出版信息

Heart Rhythm. 2010 Jun;7(6):750-4. doi: 10.1016/j.hrthm.2010.02.020. Epub 2010 Feb 16.

DOI:10.1016/j.hrthm.2010.02.020
PMID:20167289
Abstract

BACKGROUND

A new pacing system has been designed and tested preclinically for safe use in the magnetic resonance imaging (MRI) environment. Experience with this innovative system has not yet been reported.

OBJECTIVE

The purpose of this study was to verify the safety and effectiveness of this newly designed system compared to conventional DDD implant outcomes.

METHODS

Over an 11-month period, 107 consecutive patients (71 men and 36 women; age 72.6 +/- 8.5 years) were implanted with either the MRI system (n = 50; MRI group) or a dual-chamber, active-fixation lead (Medtronic 4076) non-MRI system (n = 57; DDD group). Data were collected at implant and during postoperative follow-up at 1, 3, 6, and 12 months. Procedural and fluoroscopic times at implant, as well as lead measurements, handling characteristics, and procedural-related complications, were prospectively analyzed.

RESULTS

The implantation success rate in both groups was 100%. Cephalic access was 63% for MRI patients and 70% for DDD patients (P = NS). Follow-up was obtained for all patients (median 6.8 months, range 3-12 months). At implant and at the end of follow-up, stimulation thresholds, sensing, and impedance were acceptable. No cases of high pacing thresholds or inadequate sensing were noted. No complications occurred, and no patient experienced subsequent lead displacement.

CONCLUSION

This prospective, controlled study provides strong evidence that the feasibility and safety of this novel technology compare favorably with those of the conventional technique.

摘要

背景

一种新的起搏系统已经在临床前进行了设计和测试,以确保其在磁共振成像(MRI)环境中的安全使用。目前尚未报道有关该创新系统的经验。

目的

本研究旨在验证该新设计系统与传统的双腔、主动固定导联(美敦力 4076)非 MRI 系统相比的安全性和有效性。

方法

在 11 个月的时间里,连续 107 例患者(71 名男性和 36 名女性;年龄 72.6 +/- 8.5 岁)植入了新的 MRI 系统(n = 50;MRI 组)或双腔、主动固定导联(美敦力 4076)非 MRI 系统(n = 57;DDD 组)。在植入时和术后 1、3、6 和 12 个月时收集数据。前瞻性分析植入时的手术和透视时间、导联测量值、操作特性以及与手术相关的并发症。

结果

两组的植入成功率均为 100%。MRI 患者的头侧入路为 63%,DDD 患者为 70%(P = NS)。所有患者均获得随访(中位数 6.8 个月,范围 3-12 个月)。在植入时和随访结束时,刺激阈值、感知和阻抗均在可接受范围内。未发现高起搏阈值或感知不足的情况。未发生并发症,也未发生后续导联移位。

结论

这项前瞻性、对照研究提供了强有力的证据,证明该新技术的可行性和安全性与传统技术相当。

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