Fondazione Cardimed and C.D.C. I.O.S. MF Group, Pomigliano d'Arco.
Ospedale E.E. Miulli - Acquaviva delle Fonti, Bari.
Europace. 2018 Jun 1;20(6):1001-1009. doi: 10.1093/europace/eux118.
The Really ProMRI study evaluates magnetic resonance imaging (MRI) access for patients with cardiac implantable electronic devices (CIEDs) as well as the performance of magnetic resonance (MR)-conditional leads when undergoing MRI.
Patients either with an MR-conditional pacemaker or implantable defibrillator (ICD) system or with at least a component (device or one or more leads) from an MR-conditional system, were asked to fill in a questionnaire when they were referred to a MR scan. The rate of prescription, denial, or execution of MR examinations was evaluated in a 1-year follow-up visit. In total, 555 patients [median age (interquartile range) 72.2 (62.2-78.6); 72% male] were enrolled, 49% (270) with a pacemaker, 51% (285) with an ICD system. Five-hundred and ten patients completed the follow-up period. A total of 37 MRI referrals were reported in 35 patients, with a consequent event rate of 7.0/100 patient-years (CI, 4.9-9.7). Fourteen were denied, while 23 [66%; (CI, 48-81%)] were performed. The number of patients with MR referrals was not statistically different between pacemaker and ICD groups (21 vs. 14; P = 0.178). The rate of scans performed was higher in the pacemaker subjects (19/23 vs. 4/14, P = 0.003), while it was similar between patients with or without a complete MR-conditional system (19/30 vs. 4/7, P = 0.606).
In this study, we reported a 7.0/100 patient-year's event rate of MR prescriptions in CIED patients. Many examinations were denied, despite MR-conditional systems, especially in ICD patients. Regulatory and cultural changes are needed to allow wider access to MR imaging in CIED patients with MR-conditional systems.
Really ProMRI 研究评估了心脏植入式电子设备 (CIED) 患者的磁共振成像 (MRI) 检查，并评估了 MRI 检查中具有磁共振兼容性的导线的性能。
当被转诊进行 MRI 检查时，患者要么有一个具有磁共振兼容性的起搏器或植入式除颤器 (ICD) 系统，要么至少有一个具有磁共振兼容性系统的部件（设备或一个或多个导线），被要求填写一份问卷。在为期 1 年的随访中，评估了处方、拒绝或执行 MRI 检查的比例。共有 555 名患者（中位数年龄[四分位数间距]72.2[62.2-78.6]；72%为男性）入组，49%（270 名）为起搏器患者，51%（285 名）为 ICD 系统患者。510 名患者完成了随访期。共有 35 名患者报告了 37 次 MRI 转诊，因此发生率为 7.0/100 患者年（CI，4.9-9.7）。有 14 次被拒绝，而有 23 次（66%[CI，48-81%]）进行了检查。起搏器组和 ICD 组的 MRI 转诊患者数量无统计学差异（21 名与 14 名；P=0.178）。在起搏器患者中，进行扫描的比例更高（19/23 与 4/14，P=0.003），而在具有或不具有完整磁共振兼容性系统的患者中，扫描比例相似（19/30 与 4/7，P=0.606）。
在这项研究中，我们报告了 CIED 患者进行 MRI 检查的 7.0/100 患者年事件发生率。尽管具有磁共振兼容性系统，但仍有许多检查被拒绝，尤其是在 ICD 患者中。需要进行监管和文化变革，以允许具有磁共振兼容性系统的 CIED 患者更广泛地接受磁共振成像检查。
