法国心脏病学会起搏和电生理工作组与法国心血管诊断与介入影像学会关于心脏电子植入式设备患者磁共振成像的联合立场文件。

Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the French Society of Diagnostic and Interventional Cardiac and Vascular Imaging on magnetic resonance imaging in patients with cardiac electronic implantable devices.

机构信息

Sorbonne University, Heart Institute, La Pitié-Salpêtrière University Hospital, AP-HP, 75013 Paris, France.

Cardiac Imaging Unit, Department of Radiology, Rouen University Hospital, 76031 Rouen, France.

出版信息

Arch Cardiovasc Dis. 2020 Jun-Jul;113(6-7):473-484. doi: 10.1016/j.acvd.2020.03.015. Epub 2020 May 27.

Abstract

Magnetic resonance imaging (MRI) has become the reference imaging technique for the management of a large number of diseases. The number of MRI examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). The presence of a CEID was considered an absolute contraindication for MRI for many years. The progressive replacement of conventional pacemakers and defibrillators by "magnetic resonance (MR)-conditional" CEIDs and recent data on the safety of MRI in patients with "MR-non-conditional" CEIDs have gradually increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with MR-conditional devices, because these devices are not "MR safe". Specific programming of the device in "MR mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the French Society of Diagnostic and Interventional Cardiac and Vascular Imaging describes the effect of and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional non-guaranteed" and MR-non-conditional devices.

摘要

磁共振成像(MRI)已成为许多疾病管理的参考成像技术。MRI 检查的数量每年都在增加,同时接受心脏电子植入式设备(CEID)的患者数量也在增加。多年来,CEID 的存在被认为是 MRI 的绝对禁忌症。随着“磁共振(MR)兼容”CEID 对传统起搏器和除颤器的逐步替代,以及最近关于“MR 不兼容”CEID 患者 MRI 安全性的数据,MRI 在 CEID 患者中的需求逐渐增加。然而,即使是使用“MR 兼容”CEID,MRI 也与一些风险相关,因为这些设备并非“MR 安全”。对所有携带 CEID 的患者进行设备的“MR 模式”特定编程和 MRI 期间的监测仍然是强制性的。每个进行此类检查的机构都应建立基于机构协议的标准化患者工作流程。法国心脏病学会起搏和电生理工作组与法国诊断与介入心脏病学和血管成像学会联合发表的这份立场文件描述了 MRI 在 CEID 携带者中的作用及其相关风险。我们提出了针对患者工作流程以及“MR 兼容、MR 兼容但不保证、MR 不兼容”设备中 CEID 监测和编程的建议。

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