下载PDF
{"title":"MRI in Patients with Cardiovascular Implantable Electronic Devices and Fractured or Abandoned Leads.","authors":"Mark J Greenhill, Pooja Rangan, Wilber Su, J Peter Weiss, Michael Zawaneh, Samuel Unzek, Balaji Tamarappoo, Julia Indik, Roderick Tung, Michael F Morris","doi":"10.1148/ryct.230303","DOIUrl":null,"url":null,"abstract":"<p><p>Purpose To examine the clinical effect of lead length and lead orientation in patients with cardiac implantable electronic devices (CIEDs) and lead fragments or abandoned leads undergoing 1.5-T MRI. Materials and Methods This Health Insurance Portability and Accountability Act-compliant retrospective study included patients with CIEDs and abandoned leads or lead fragments undergoing 1.5-T MRI from March 2014 through July 2020. CIED settings before and after MRI were reviewed, with clinically significant variations defined as a composite of the change in capture threshold of at least 50%, in sensing of at least 40%, or in lead impedance of at least 30% between before MRI and after MRI interrogation. Adverse clinical events were assessed at MRI and up to 30 days after. Univariable and multivariable analysis was performed. Results Eighty patients with 126 abandoned CIED leads or lead fragments underwent 107 1.5-T MRI examinations. Sixty-seven patients (median age, 74 years; IQR, 66-78 years; 44 male patients, 23 female patients) had abandoned leads, and 13 (median age, 66 years; IQR, 52-74 years; nine male patients, four female patients) had lead fragments. There were no reported deaths, clinically significant arrhythmias, or adverse clinical events within 30 days of MRI. Three patients with abandoned leads had a significant change in the composite of capture threshold, sensing, or lead impedance. In a multivariable generalized estimating equation analysis, lead orientation, lead length, MRI type, and MRI duration were not associated with a significant change in the composite outcome. Conclusion Use of 1.5-T MRI in patients with abandoned CIED leads or lead fragments of varying length and orientation was not associated with adverse clinical events. <b>Keywords:</b> Cardiac Assist Devices, MRI, Cardiac Implantable Electronic Device <i>Supplemental material is available for this article.</i> © RSNA, 2024.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. Cardiothoracic imaging","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211945/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology. Cardiothoracic imaging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1148/ryct.230303","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
引用
批量引用
Abstract
Purpose To examine the clinical effect of lead length and lead orientation in patients with cardiac implantable electronic devices (CIEDs) and lead fragments or abandoned leads undergoing 1.5-T MRI. Materials and Methods This Health Insurance Portability and Accountability Act-compliant retrospective study included patients with CIEDs and abandoned leads or lead fragments undergoing 1.5-T MRI from March 2014 through July 2020. CIED settings before and after MRI were reviewed, with clinically significant variations defined as a composite of the change in capture threshold of at least 50%, in sensing of at least 40%, or in lead impedance of at least 30% between before MRI and after MRI interrogation. Adverse clinical events were assessed at MRI and up to 30 days after. Univariable and multivariable analysis was performed. Results Eighty patients with 126 abandoned CIED leads or lead fragments underwent 107 1.5-T MRI examinations. Sixty-seven patients (median age, 74 years; IQR, 66-78 years; 44 male patients, 23 female patients) had abandoned leads, and 13 (median age, 66 years; IQR, 52-74 years; nine male patients, four female patients) had lead fragments. There were no reported deaths, clinically significant arrhythmias, or adverse clinical events within 30 days of MRI. Three patients with abandoned leads had a significant change in the composite of capture threshold, sensing, or lead impedance. In a multivariable generalized estimating equation analysis, lead orientation, lead length, MRI type, and MRI duration were not associated with a significant change in the composite outcome. Conclusion Use of 1.5-T MRI in patients with abandoned CIED leads or lead fragments of varying length and orientation was not associated with adverse clinical events. Keywords: Cardiac Assist Devices, MRI, Cardiac Implantable Electronic Device Supplemental material is available for this article. © RSNA, 2024.
心血管植入式电子设备和导线断裂或脱落患者的核磁共振成像。
目的 研究在接受 1.5-T 磁共振成像检查的心脏植入式电子装置(CIED)和导联碎片或废弃导联患者中,导联长度和导联方向的临床影响。材料和方法 这项符合《健康保险可携性和责任法案》的回顾性研究纳入了从 2014 年 3 月到 2020 年 7 月接受 1.5-T 磁共振成像检查的 CIED 和废弃导线或导线碎片患者。对磁共振成像前后的 CIED 设置进行了审查,具有临床意义的变化是指磁共振成像前和磁共振成像检查后捕获阈值变化至少 50%、传感变化至少 40% 或导联阻抗变化至少 30% 的综合结果。不良临床事件在核磁共振成像时和成像后 30 天内进行评估。进行了单变量和多变量分析。结果 80名患者共接受了107次1.5 T磁共振成像检查,其中有126个被遗弃的CIED导线或导线碎片。67名患者(中位年龄 74 岁;IQR 66-78 岁;44 名男性患者,23 名女性患者)有废弃导线,13 名患者(中位年龄 66 岁;IQR 52-74 岁;9 名男性患者,4 名女性患者)有导线碎片。在核磁共振成像后的 30 天内,没有死亡病例、有临床意义的心律失常或不良临床事件的报告。三位有弃导联的患者在捕获阈值、传感或导联阻抗的综合指标上有显著变化。在多变量广义估计方程分析中,导联方向、导联长度、磁共振成像类型和磁共振成像持续时间与综合结果的显著变化无关。结论 在有废弃CIED导联或不同长度和方向的导联碎片的患者中使用1.5T磁共振成像与不良临床事件无关。关键词心脏辅助装置、核磁共振成像、心脏植入式电子装置 本文有补充材料。© RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。