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心脏植入式电子设备患者的磁共振成像:RESONANCE 西班牙注册研究。

Magnetic resonance imaging in patients with cardiac implantable electronic devices: the RESONANCE Spanish registry.

机构信息

Cardiology Department, Hospital Universitario Costa del Sol, A-7, Km 187, 29603 Marbella, Málaga, Spain.

Cardiology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.

出版信息

Europace. 2024 Nov 1;26(11). doi: 10.1093/europace/euae277.

Abstract

AIMS

Despite increasing evidence demonstrating the safety of magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices (CIEDs), this procedure is often neglected in this population. This Spanish registry aimed to determine the proportion of MRI referrals and performance among patients with pacemakers (PMs) or implantable cardioverter defibrillators (ICDs).

METHODS AND RESULTS

This prospective, multicentre, open-label registry involved 21 Spanish centres. Data were collected upon implant of PMs or ICDs from BIOTRONIK and one year after, and included the number of MRIs and computed tomography scans prescribed, performed and denied, and reasons for denial. Data from 1105 patients (mean age: 74.2 years) were analysed and 982 completed the follow-up. Of them, 82.2% had a PM and 17.8% an ICD. A total of 351 imaging tests were prescribed in 220 patients (19.9%), including 52 MRIs in 39 patients (3.5%) and 299 computed tomography scans in 196 patients (17.8%). Among the MRIs, 44 (84.6%) were performed, five (9.6%) were not performed, and three (5.8%) were replaced by an alternative test. Most of the indicated computed tomography scans were performed (97.7%). The proportion of patients with an MRI scan referral was 4.6% during the pre-COVID-19 period and 2.6% during the COVID-19 period. No MRI-related arrhythmic ventricular event was reported.

CONCLUSION

This registry revealed that only 3.5% of patients with CIEDs had an MRI referral over the study, with rates decreasing to 2.6% during the COVID-19 period. These rates contrast with the 85 MRIs conducted per 1000 inhabitants in Spain in 2020.

摘要

目的

尽管越来越多的证据表明磁共振成像(MRI)在患有心脏植入式电子设备(CIED)的患者中是安全的,但该程序在该人群中经常被忽视。这项西班牙注册研究旨在确定起搏器(PM)或植入式心律转复除颤器(ICD)患者中 MRI 转诊和实施的比例。

方法和结果

这项前瞻性、多中心、开放性注册研究涉及 21 个西班牙中心。在 BIOTRONIK 植入 PM 或 ICD 时以及一年后收集数据,包括规定、进行和拒绝的 MRI 和计算机断层扫描的数量,以及拒绝的原因。共分析了 1105 名患者(平均年龄:74.2 岁)的数据,其中 982 名患者完成了随访。他们中 82.2%为 PM,17.8%为 ICD。在 220 名患者(19.9%)中规定了 351 项影像学检查,包括 39 名患者(3.5%)的 52 项 MRI 和 196 名患者(17.8%)的 299 项计算机断层扫描。在 MRI 中,有 44 项(84.6%)得到了实施,5 项(9.6%)未得到实施,3 项(5.8%)被替代试验所取代。大多数规定的计算机断层扫描都得到了实施(97.7%)。在 COVID-19 前和 COVID-19 期间,有 MRI 扫描转诊的患者比例分别为 4.6%和 2.6%。没有报告与 MRI 相关的心律失常性室性事件。

结论

该注册研究表明,在研究期间,只有 3.5%的 CIED 患者有 MRI 转诊,在 COVID-19 期间这一比例降至 2.6%。这些比率与 2020 年西班牙每 1000 名居民进行 85 次 MRI 形成鲜明对比。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac94/11572718/683db6368f99/euae277_ga.jpg

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