Lanz Hugo, Strauß Katharina, Höpler Julia, Kraft Marie, Hoffmann Sabine, Binzenhöfer Leonhard, Gade Nils, Roden Daniel, Saleh Inas, Kääb Stefan, Lackermair Korbinian, Sadoni Sebastian, Hagl Christian, Massberg Steffen, Estner Heidi, Fichtner Stephanie, Lüsebrink Enzo
Department of Medicine I, LMU University Hospital, 81377 Munich, Germany.
DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, 80636 Munich, Germany.
J Cardiovasc Dev Dis. 2024 Oct 8;11(10):313. doi: 10.3390/jcdd11100313.
MRI (magnetic resonance imaging) represents the diagnostic image modality of choice in several conditions. With an increasing number of patients requiring MRI for diagnostic purposes, the issue of safety in patients with cardiac implantable electronic devices (CIED) undergoing this imaging modality will play an ever more important role. The purpose of this study was to assess the safety and device function following MRI in an unrestricted real-world cohort of patients with a wide array of cardiac devices.
We conducted a retrospective single-center study including 1010 MRI studies conducted in adult patients (≥18 years) with an implanted CIED treated in the University Hospital of Munich (LMU) between July 2012 and March 2024. Patients with non-MR conditionally labeled leads, abandoned or epicardial leads, as well as lead fragments, were included for analysis.
Across a total of 1010 MRIs (920 total MR-conditional device generators) performed in patients with an implanted CIED, there were no deaths, reports of discomfort, palpitations, heating, or ventricular arrythmias in the 24 h following MRI. Only 2/1010 MRIs were followed by a reported atrial arrhythmia within 24 h, both in patients with an MR-conditional pacemaker (PM) device without an abandoned lead. No significant changes in device function following MRI from baseline were observed across all included CIEDs. Lastly, no instances of severe malfunction, such as generator failure, loss of capture, electrical reset, or inappropriate inhibition of pacing, were found in post-MRI interrogation reports across all MRI studies.
Based on the analysis of 1010 MRIs undergone by patients with CIEDs, following standardized device interrogation, manufacturer-advised device programming, monitoring of vital function, and manufacturer-advised reprogramming, MRI can be performed safely and without adverse events or changes in device function.
磁共振成像（MRI）是多种病症诊断的首选成像方式。随着越来越多的患者因诊断需要接受MRI检查，心脏植入式电子设备（CIED）患者接受这种成像方式时的安全性问题将发挥越来越重要的作用。本研究的目的是评估在一个不受限制的真实世界队列中，接受MRI检查的各类心脏设备患者的安全性和设备功能。
我们进行了一项回顾性单中心研究，纳入了2012年7月至2024年3月在慕尼黑大学医院（LMU）接受治疗的成年（≥18岁）植入CIED患者的1010例MRI检查。纳入分析的患者包括带有非MR条件标记导线、废弃或心外膜导线以及导线碎片的患者。
在植入CIED的患者中总共进行了1010次MRI检查（920个总的MR条件设备发生器），MRI检查后24小时内没有死亡、不适、心悸、发热或室性心律失常的报告。仅1010次MRI检查中有2次在24小时内报告了房性心律失常，均发生在没有废弃导线的MR条件起搏器（PM）设备患者中。在所有纳入的CIED中，未观察到MRI检查后设备功能与基线相比有显著变化。最后，在所有MRI研究的MRI检查后询问报告中，未发现严重故障的情况，如发生器故障、捕获丧失、电重置或不适当的起搏抑制。
基于对1010例CIED患者进行的MRI检查分析，在进行标准化设备询问、按照制造商建议进行设备编程、监测生命功能以及按照制造商建议重新编程后，可以安全地进行MRI检查，且不会出现不良事件或设备功能变化。
