Marczak Magdalena, Świerżyńska Ewa, Śpiewak Mateusz, Bodusz Dawid, Klotzka Aneta, Mitkowski Przemysław, Tajstra Mateusz, Hryniewiecki Tomasz, Serafin Zbigniew, Sterliński Maciej, Michałowska Ilona
The Cardinal Stefan Wyszyński National Institute of Cardiology, Warsaw, Poland.
Doctoral School, Medical University of Warsaw, Warsaw, Poland.
Pol J Radiol. 2024 Jan 4;89:e1-e5. doi: 10.5114/pjr.2023.133306. eCollection 2024.
The year 2023 marks 60 years since the first pacemaker was implanted in Poland. The number of implantable cardiac electrotherapy devices (CIEDs), including pacemakers, cardioverter-defibrillators, and resynchronization therapy systems, has been systematically increasing in the subsequent decades. It is estimated that nearly 500,000 Poles have an implanted cardiac electrotherapy device, making optimal diagnostic imaging with the use of magnetic resonance imaging (MRI) a clinically and epidemiologically important issue. MRI has become a gold diagnostic standard in many disease states. In this situation, it is believed that 50-70% of patients who have a cardiac electrotherapy device may have indications for an MRI examination later in life. For many years, an implanted cardiac electrotherapy device was considered a definite contraindication to MRI. However, MRI has become possible in most patients with CIED if certain procedures and precautions are followed. In these guidelines, we describe the basic rules that should be followed in order to perform a safe MRI examination in patients with different CIEDs. Despite all the risks and organizational factors described in the text, it seems that for many MRI departments, MRI in patients with CIEDs is achievable and should be implemented immediately. A second important issue is the need for dedicated financial support for these procedures from public health insurance.
2023年是波兰首次植入起搏器60周年。在随后的几十年里，包括起搏器、心脏复律除颤器和心脏再同步治疗系统在内的植入式心脏电治疗设备（CIED）的数量一直在系统性增加。据估计，近50万波兰人植入了心脏电治疗设备，因此，利用磁共振成像（MRI）进行最佳诊断成像成为一个在临床和流行病学上都很重要的问题。MRI已成为许多疾病状态下的黄金诊断标准。在这种情况下，据信50%至70%植入心脏电治疗设备的患者在以后的生活中可能有进行MRI检查的指征。多年来，植入式心脏电治疗设备一直被视为MRI的绝对禁忌症。然而，如果遵循某些程序和预防措施，大多数CIED患者也可以进行MRI检查。在本指南中，我们描述了对不同CIED患者进行安全MRI检查时应遵循的基本规则。尽管本文中描述了所有风险和组织因素，但对于许多MRI科室来说，对CIED患者进行MRI检查似乎是可行的，应该立即实施。第二个重要问题是公共医疗保险需要为这些程序提供专门的财政支持。
