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心脏植入式电子设备的远程编程:一种为磁共振成像对心脏设备进行编程的新方法。

Remote programming of cardiac implantable electronic devices: A novel approach to program cardiac devices for magnetic resonance imaging.

作者信息

Siddamsetti Sisir, Shinn Alexander, Gautam Sandeep

机构信息

Division of Cardiovascular Medicine, University of Missouri Columbia, Columbia, Missouri, USA.

出版信息

J Cardiovasc Electrophysiol. 2022 May;33(5):1005-1009. doi: 10.1111/jce.15434. Epub 2022 Mar 12.

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) in patients with MRI-conditional cardiovascular implantable electronic devices (CIED) remain a logistical issue for device programming during the scan. In current practice, a trained person needs to be present on-site to program CIED for MRI scan. This can cause delay in patient care, rescheduling of tests and increase healthcare costs. A novel remote programming (RP) strategy can be utilized to reprogram the CIED remotely. We sought to explore the feasibility and safety of RP of CIEDs in patients undergoing MRI scan.

METHODS

We implemented the Medtronic CIED RP software at our institution after ensuring HIPAA compliance. The MRI technician started the session by contacting an off-site remote operator and placing a programmer wand from the 2090 Medtronic programmer over the CIED. The remote operator logged into a remote access software and provided a unique access code to the MRI technician. After entering the access code into the programmer, the remote operator was able to program the device as needed. We conducted a periodic audit of the first 209 patients who underwent RP of CIEDs for MRI. Outcomes analyzed were successful completion of RP sessions and time saved per scan.

RESULTS

Of the 209 MRI scans, 51 scans were performed urgently. There were no connectivity and programming problems or need for MRI rescheduling. In-person reprogramming was not required for any patient. All scans were completed safely in a timely manner, and there were no reports of CIED malfunction. Time saved per scan was estimated to be 28 ± 10 min.

CONCLUSIONS

Remote programming of CIEDs for MRI scans is a safe and effective strategy.

摘要

背景

对于植入磁共振成像(MRI)兼容型心血管植入式电子设备(CIED)的患者,在扫描期间对设备进行编程仍是一个后勤问题。在当前实践中,需要有经过培训的人员在现场为MRI扫描对CIED进行编程。这可能导致患者护理延迟、检查重新安排,并增加医疗成本。可以采用一种新型的远程编程(RP)策略来对CIED进行远程重新编程。我们试图探讨在接受MRI扫描的患者中对CIED进行RP的可行性和安全性。

方法

在确保符合健康保险流通与责任法案(HIPAA)后,我们在本机构实施了美敦力CIED RP软件。MRI技术人员通过联系场外远程操作员并将美敦力2090编程器的编程棒置于CIED上方来启动会话。远程操作员登录远程访问软件并向MRI技术人员提供唯一的访问代码。在将访问代码输入编程器后,远程操作员能够根据需要对设备进行编程。我们对前209例接受CIED的MRI扫描RP的患者进行了定期审核。分析的结果是RP会话的成功完成以及每次扫描节省的时间。

结果

在209次MRI扫描中,51次扫描是紧急进行的。没有连接和编程问题,也无需重新安排MRI检查。所有患者均无需进行现场重新编程。所有扫描均及时安全完成,且无CIED故障报告。每次扫描节省的时间估计为28±10分钟。

结论

对CIED进行MRI扫描的远程编程是一种安全有效的策略。

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