Division of Gastroenterology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada.
Can J Gastroenterol Hepatol. 2017;2017:7298032. doi: 10.1155/2017/7298032. Epub 2017 Feb 27.
. Emerging evidence suggests that nonalcoholic fatty liver disease (NAFLD) is associated with coronary artery diseases and arrhythmias. The FibroScan (Echosens, France), a widely available, noninvasive device, is able to detect liver fibrosis and steatosis within this patient population. However, the FibroScan is currently contraindicated in patients with cardiac pacemakers (PM) or implantable cardioverter-defibrillators (ICD). . To determine the safety profile of FibroScan testing in patients with PM or ICD. . Consecutive outpatients undergoing routine device interrogations at a tertiary level teaching hospital underwent simultaneous liver stiffness measurements. PM or ICD performance data, device types, patient demographics, medical history, and previous laboratory and conventional liver imaging results were collected. . Analysis of 107 subjects with 33 different types of implanted cardiac devices, from 5 different companies (Medtronic, Sorin, ELA Medical, Boston Scientific, and St. Jude), did not demonstrate any adverse events as defined by abnormal device sensing/pacing or ICD firing. This population included high risk subjects undergoing active pacing ( = 53) and with right pectoral PM placement ( = 1). None of the subjects had any clinical signs of decompensated congestive heart failure or cirrhosis during the exam. . TE with FibroScan can be safely performed in patients with PM or ICD.
有新的证据表明,非酒精性脂肪性肝病(NAFLD)与冠状动脉疾病和心律失常有关。FibroScan(Echosens,法国)是一种广泛应用的非侵入性设备,能够在该患者人群中检测到肝纤维化和脂肪变性。然而,FibroScan 目前在带有心脏起搏器(PM)或植入式心脏复律除颤器(ICD)的患者中被禁用。
为了确定 FibroScan 检测在 PM 或 ICD 患者中的安全性。
在一家三级教学医院进行常规设备检查的连续门诊患者同时进行了肝脏硬度测量。收集了 PM 或 ICD 的性能数据、设备类型、患者人口统计学、病史以及以前的实验室和常规肝脏成像结果。
对来自 5 家不同公司(美敦力、索林、ELA Medical、波士顿科学和圣犹达)的 33 种不同类型植入式心脏设备的 107 名患者进行了分析,没有发现任何异常设备感知/起搏或 ICD 触发定义的不良事件。该人群包括正在进行主动起搏(=53)和右胸肌 PM 放置(=1)的高危患者。在检查过程中,没有患者出现失代偿性充血性心力衰竭或肝硬化的临床迹象。
TE 联合 FibroScan 可安全用于 PM 或 ICD 患者。