Bireley Madeline, Kovach Joshua R, Morton Candace, Cava Joseph R, Pan Amy Y, Nugent Melodee, Samyn Margaret M
Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Pediatr Cardiol. 2020 Apr;41(4):801-808. doi: 10.1007/s00246-020-02316-z. Epub 2020 Mar 12.
Magnetic resonance imaging (MRI) of patients with pacemakers remains concerning because of possible magnetic field effects on the device. Many pacemaker models are labeled as non-conditional, or contraindicated for MRI, or do not have any specific safety guidelines listed. This study describes our experience with pacemaker function and adverse events in pediatric and young adult patients after clinically indicated MRI scanning at 1.5 Tesla (T). We hypothesized that generator battery voltage, pacemaker lead threshold, and lead impedance would not be altered by MRI. This was a retrospective review of Children's Wisconsin clinical MRI data for all patients with pacemakers scanned between January 1, 2010 and March 31, 2018. Pacemakers were interrogated by the Electrophysiology Team before and immediately after MRI and at outpatient follow up. Twenty-one patients underwent forty-four MRI scans. No significant immediate changes were seen in any pacemaker parameter for any manufacturer/model/lead at the time of MRI. At first clinical follow up post MRI, (median 4.4 months, range 0.2-12.3), battery voltage was reduced (2.78 V pre-MRI versus 2.77 V at follow up, p = 0.02), but there were no other significant changes. No adverse events were noted. Pediatric patients with pacemakers, including those with epicardial leads, can be scanned at 1.5 T safely without alteration in pacemaker function. Using appropriate precautions, pediatric patients with pacemakers can be imaged with MRI.
由于磁场可能对起搏器产生影响，因此有起搏器的患者进行磁共振成像（MRI）检查仍令人担忧。许多起搏器型号被标记为非禁忌，或禁忌MRI检查，或未列出任何具体的安全指南。本研究描述了我们在1.5特斯拉（T）的临床指示MRI扫描后，对儿科和年轻成年患者起搏器功能及不良事件的经验。我们假设MRI不会改变发生器电池电压、起搏器导线阈值和导线阻抗。这是一项对2010年1月1日至2018年3月31日期间接受扫描的所有有起搏器患者的威斯康星儿童医院临床MRI数据的回顾性研究。在MRI检查前、检查后立即以及门诊随访时，由电生理团队对起搏器进行问询。21名患者接受了44次MRI扫描。在MRI检查时，任何制造商/型号/导线的任何起搏器参数均未出现明显的即时变化。在MRI后的首次临床随访中（中位时间4.4个月，范围0.2 - 12.3个月），电池电压降低（MRI前为2.78V，随访时为2.77V，p = 0.02），但没有其他显著变化。未观察到不良事件。有起搏器的儿科患者，包括那些有心外膜导线的患者，可以在1.5T下安全扫描，且起搏器功能不会改变。采取适当的预防措施后，有起搏器的儿科患者可以进行MRI成像。
