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ProMRI 起搏器系统在接受胸部脊柱和心脏 1.5-T 磁共振成像扫描条件下的临床安全性。

Clinical safety of the ProMRI pacemaker system in patients subjected to thoracic spine and cardiac 1.5-T magnetic resonance imaging scanning conditions.

机构信息

Louisiana Heart Rhythm Specialists and Lafayette General Medical Center, Lafayette, Louisiana.

University of Iowa Hospitals and Clinics, Iowa City, Iowa.

出版信息

Heart Rhythm. 2016 Feb;13(2):464-71. doi: 10.1016/j.hrthm.2015.09.021. Epub 2015 Sep 25.

Abstract

BACKGROUND

Permanent cardiac pacemakers have historically been considered a contraindication to magnetic resonance imaging (MRI).

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

永久性心脏起搏器一直被认为是磁共振成像(MRI)的禁忌症。

目的

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。

方法

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。

结果

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)。

结论

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。

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