Department of Cardiology, Hospital Universitario de Valme, Seville, Spain.
Department of Cardiology, Arrhythmias Unit, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
Magn Reson Imaging. 2022 Sep;91:9-15. doi: 10.1016/j.mri.2022.05.004. Epub 2022 May 6.
The number of patients with cardiac implantable electronic devices in whom magnetic resonance imaging (MRI) is indicated is constantly increasing. The potential risk of electromagnetic interference has limited its use and it is still contraindicated by the Food and Drug Administration in some cases. The aim of this study is to evaluate the safety and efficacy of MRI in these patients.
A prospective registry comprising patients with a pacemaker (PM) or implantable cardioverter-defibrillator (ICD), MRI-conditional or not, who were candidates for MRI (at 1.5 T) with no suitable alternative diagnostic technique. All devices were programmed before the procedure and patients were monitored throughout the test. Clinical, electrical, and technical parameters were evaluated before and after MRI.
147 MRI examinations (132 PM and 15 ICD) were performed. There were no clinical events or significant differences in the electrical parameters of the leads after MRI. A variation in the impedance of the ventricular leads was detected, although the difference was not clinically relevant. In one patient with a PM, a failure in release of the safety impulse was detected in the auto-threshold test, although the threshold was correctly determined. In 11 of the 17 thoracic MRIs, image artifacts were detected, preventing the diagnosis in two of them.
In patients with cardiac implantable electronic devices, MRIs performed under a specific protocol has been shown to be safe in the short term even in the thoracic region, as well as interpretable in most cases.
需要进行磁共振成像（MRI）的心脏植入式电子设备患者数量不断增加。由于存在电磁干扰的潜在风险，限制了其使用，并且在某些情况下，美国食品和药物管理局仍然禁止使用。本研究旨在评估这些患者进行 MRI 的安全性和有效性。
一项前瞻性注册研究纳入了符合以下条件的患者：有起搏器（PM）或植入式心律转复除颤器（ICD），无论是否可进行 MRI，都是 MRI（1.5T）的候选者，且没有合适的替代诊断技术。所有设备均在程序前进行编程，并在整个测试过程中对患者进行监测。在 MRI 前后评估临床、电气和技术参数。
共进行了 147 次 MRI 检查（132 次 PM 和 15 次 ICD）。MRI 后没有临床事件或导线电参数发生显著变化。尽管差异无临床意义，但检测到心室导线阻抗发生变化。在一名 PM 患者中，自动阈值测试中检测到安全脉冲释放失败，但阈值正确确定。在 17 次胸部 MRI 中，有 11 次检测到图像伪影，其中 2 次影像无法诊断。
在心脏植入式电子设备患者中，根据特定方案进行的 MRI 在短期内是安全的，即使在胸部区域也是如此，并且在大多数情况下是可解释的。
