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近期植入起搏器患者的磁共振成像

Magnetic resonance imaging in patients with recently implanted pacemakers.

作者信息

Friedman Hannah L, Acker Nancy, Dalzell Connie, Shen Win K, Asirvatham Samuel J, Cha Yong-Mei, Hodge David, Felmlee Joel, Watson Robert, Friedman Paul A

机构信息

Heart Rhythm Services, Mayo Clinic, Rochester, Minnesota.

出版信息

Pacing Clin Electrophysiol. 2013 Sep;36(9):1090-5. doi: 10.1111/pace.12213. Epub 2013 Jul 4.

Abstract

BACKGROUND

Recent studies have shown that magnetic resonance imaging (MRI) of patients with pacemakers can be safely performed under careful monitoring, but they excluded patients with recently implanted devices. Patients with recent implants may be at a greater risk for complications during MRI imaging due to lack of lead and wound maturity.

METHODS

We implemented a clinical protocol for MRI imaging of patients with implanted cardiac devices, and prospectively collected data. For this study, we retrospectively analyzed two groups of patients: those with recently implanted (≤42 days) and nonrecently implanted (>42 days) leads at the time of MRI scanning. All devices were interrogated before and after scanning, and were reprogrammed during the scan as per protocol.

RESULTS

Of the 219 scans (in 171 patients), eight included patients with recently implanted (range: 7-36 days) and 211 with only nonrecently implanted pacemaker leads. During the scan, there were no complications in the early or late group. In one patient imaged 79 days postimplant, frequent premature ventricular complexes were noted during the scan, requiring no action. No patient reported pain during or immediately after the procedure. No clinically significant changes in function were seen at subsequent follow up (average 104 days post-MRI). Compared to patients with nonrecently implanted leads, there was no difference in any parameter between the two groups.

CONCLUSIONS

With a strong clinical indication and with careful monitoring, MRI imaging is feasible in patients with recently implanted pacemakers, although experience is limited.

摘要

背景

最近的研究表明,在仔细监测下,对植入起搏器的患者进行磁共振成像(MRI)是安全的,但这些研究排除了近期植入设备的患者。由于导线和伤口未成熟,近期植入的患者在MRI成像期间发生并发症的风险可能更高。

方法

我们实施了一项针对植入心脏设备患者的MRI成像临床方案,并前瞻性地收集数据。在本研究中,我们回顾性分析了两组患者:MRI扫描时近期植入(≤42天)和非近期植入(>42天)导线的患者。所有设备在扫描前后均进行了问询,并根据方案在扫描期间重新编程。

结果

在219次扫描(171例患者)中,8次扫描的患者为近期植入(范围:7 - 36天),211次扫描的患者仅为非近期植入起搏器导线。在扫描过程中,早期和晚期组均未出现并发症。在1例植入后79天成像的患者中,扫描期间发现频发室性早搏,无需处理。术后或术后即刻无患者报告疼痛。在随后的随访中(MRI后平均104天),未观察到功能上有临床意义的变化。与非近期植入导线的患者相比,两组之间在任何参数上均无差异。

结论

尽管经验有限,但在有强烈临床指征并仔细监测的情况下,近期植入起搏器的患者进行MRI成像是可行的。

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