Louisiana Heart Rhythm Specialists and Lafayette General Medical Center, Lafayette, Louisiana.
University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Heart Rhythm. 2016 Feb;13(2):464-71. doi: 10.1016/j.hrthm.2015.09.021. Epub 2015 Sep 25.
Permanent cardiac pacemakers have historically been considered a contraindication to magnetic resonance imaging (MRI).
The purpose of the ProMRI Phase B Study, a multicenter, prospective, single-arm, nonrandomized study, was to evaluate the clinical safety of the Biotronik ProMRI pacemaker system in patients undergoing thoracic spine and cardiac MRI.
The ProMRI Phase B study enrolled 245 patients with stable baseline pacing indices implanted with an Entovis pacemaker (DR-T or SR-T) and Setrox 53-cm and/or 60-cm lead(s). Device interrogation was performed at enrollment, pre- and post-MRI scan, and 1 and 3 months post-MRI. End-points were (1) freedom from MRI- and pacing system-related serious adverse device effects through 1 month post-MRI; (2) freedom from atrial and ventricular MRI-induced pacing threshold increase (>0.5 V); and (3) freedom from P- and R-wave amplitude attenuation (<50%), or P wave <1.5 mV, or R wave <5.0 mV at 1 month post-MRI.
In total, 216 patients completed the MRI and 1-month post-MRI follow-up. One adverse event possibly related to the implanted system and the MRI procedure occurred, resulting in a serious adverse device effect-free rate of 99.6% (220/221; P < .0001. Freedom from atrial and ventricular pacing threshold increase was 100% (194/194, P < .001) and 100% (206/206, P < .001) respectively. Freedom from P- and R-wave amplitude attenuation was 98.2% (167/170, P < .001) and 100% (188/188, P < .001) respectively.
The results of the ProMRI Phase B study demonstrate the clinical safety and efficacy of the ProMRI pacemaker system in patients subjected to thoracic spine and cardiac MRI conditions.
永久性心脏起搏器一直被认为是磁共振成像(MRI)的禁忌症。
ProMRI 阶段 B 研究是一项多中心、前瞻性、单臂、非随机研究,旨在评估 Biotronik ProMRI 起搏器系统在接受胸部脊柱和心脏 MRI 的患者中的临床安全性。
ProMRI 阶段 B 研究纳入了 245 名基线起搏指数稳定的患者,他们植入了 Entovis 起搏器(DR-T 或 SR-T)和 Setrox 53-cm 和/或 60-cm 导联。在入组时、MRI 扫描前后以及 MRI 后 1 个月和 3 个月进行设备检测。终点是(1)MRI 和起搏系统相关严重不良设备效应的无发生率,直至 MRI 后 1 个月;(2)无心房和心室 MRI 诱导的起搏阈值增加(>0.5 V);(3)无 P-和 R-波振幅衰减(<50%),或 MRI 后 1 个月时 P 波<1.5 mV,或 R 波<5.0 mV。
共有 216 名患者完成了 MRI 和 MRI 后 1 个月的随访。发生了 1 起可能与植入系统和 MRI 程序相关的不良事件,导致严重不良设备效应发生率为 99.6%(220/221;P<.0001)。无心房和心室起搏阈值增加的发生率分别为 100%(194/194,P<.001)和 100%(206/206,P<.001)。无 P-和 R-波振幅衰减的发生率分别为 98.2%(167/170,P<.001)和 100%(188/188,P<.001)。
ProMRI 阶段 B 研究的结果表明,ProMRI 起搏器系统在接受胸部脊柱和心脏 MRI 条件的患者中具有临床安全性和有效性。