Objectives: To investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD). Methods: We prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted <6 weeks before enrolment or prior to 01/01/2000, with cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG). Results: 142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71). In the RG 98 measurements were performed in 95 patients with cPM (n=40) or cICD (n=58). No adverse events were observed. No MRI prolonged/interrupted. All cPM/cICD were correctly reprogrammed after MRI without malfunctions. One temporary communication failure was observed in one cPM-carrier. Immediately after MRI, 12/14 device interrogation parameters did not change significantly (clinically negligible changes of battery voltage and cICD charging time), without significant variations for SG versus RG. Three–12 months after MRI, 9/11 device interrogation parameters did not change significantly (clinically negligible changes of battery impedance/voltage). Non-significant changes of three markers of myocardial necrosis. Non-cardiac MRI: 82/87 diagnostic without artefacts; 4/87 diagnostic with artefacts; 1/87 partially diagnostic. Cardiac MRI: in cPM-carriers, 14/15 diagnostic with artefacts, 1/15 partially diagnostic; in cICD-carriers, 9/40 diagnostic with artefacts, 22 partially diagnostic, nine non-diagnostic. Conclusions: A favourable risk-benefit ratio of 1.5-T MRI in cPM/cICD carriers was reported. Key points: • Cooperation between radiologists and cardiac electrophysiologists allowed safe 1.5-T MRI in cPM/cICD-carriers.• No adverse events for 142 MRI in 71 cPM-carriers and 71 cICD-carriers.• Ninety-nine per cent (86/87) of non-cardiac MRI in cPM/cICD-carriers were diagnostic.• All cPM-carrier cardiac MRIs had artefacts, 14 examinations diagnostic, 1 partially diagnostic.• Twenty-three per cent (9/40) of cardiac MRI in cICD-carriers were non-diagnostic.

An eight-year prospective controlled study about the safety and diagnostic value of cardiac and non-cardiac 1.5-T MRI in patients with a conventional pacemaker or a conventional implantable cardioverter defibrillator / P. Lupo, R. Cappato, G. Di Leo, F. Secchi, G.D.E. Papini, S. Foresti, H. Ali, G.M.G. de Ambroggi, A. Sorgente, G. Epicoco, P.M. Cannaò, F. Sardanelli. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - 28:6(2018), pp. 2406-2416. [10.1007/s00330-017-5098-z]

An eight-year prospective controlled study about the safety and diagnostic value of cardiac and non-cardiac 1.5-T MRI in patients with a conventional pacemaker or a conventional implantable cardioverter defibrillator

F. Secchi;G.D.E. Papini;P.M. Cannaò;F. Sardanelli
2018

Abstract

Objectives: To investigate safety and diagnostic value of 1.5-T MRI in carriers of conventional pacemaker (cPM) or conventional implantable defibrillator (cICD). Methods: We prospectively compared cPM/cICD-carriers undergoing MRI (study group, SG), excluding those device-dependent or implanted <6 weeks before enrolment or prior to 01/01/2000, with cPM/cICD-carriers undergoing chest x-ray, CT or follow-up (reference group, RG). Results: 142 MRI (55 cardiac) were performed in 120 patients with cPM (n=71) or cICD (n=71). In the RG 98 measurements were performed in 95 patients with cPM (n=40) or cICD (n=58). No adverse events were observed. No MRI prolonged/interrupted. All cPM/cICD were correctly reprogrammed after MRI without malfunctions. One temporary communication failure was observed in one cPM-carrier. Immediately after MRI, 12/14 device interrogation parameters did not change significantly (clinically negligible changes of battery voltage and cICD charging time), without significant variations for SG versus RG. Three–12 months after MRI, 9/11 device interrogation parameters did not change significantly (clinically negligible changes of battery impedance/voltage). Non-significant changes of three markers of myocardial necrosis. Non-cardiac MRI: 82/87 diagnostic without artefacts; 4/87 diagnostic with artefacts; 1/87 partially diagnostic. Cardiac MRI: in cPM-carriers, 14/15 diagnostic with artefacts, 1/15 partially diagnostic; in cICD-carriers, 9/40 diagnostic with artefacts, 22 partially diagnostic, nine non-diagnostic. Conclusions: A favourable risk-benefit ratio of 1.5-T MRI in cPM/cICD carriers was reported. Key points: • Cooperation between radiologists and cardiac electrophysiologists allowed safe 1.5-T MRI in cPM/cICD-carriers.• No adverse events for 142 MRI in 71 cPM-carriers and 71 cICD-carriers.• Ninety-nine per cent (86/87) of non-cardiac MRI in cPM/cICD-carriers were diagnostic.• All cPM-carrier cardiac MRIs had artefacts, 14 examinations diagnostic, 1 partially diagnostic.• Twenty-three per cent (9/40) of cardiac MRI in cICD-carriers were non-diagnostic.
Conventional implantable cardioverter defibrillators; Conventional pacemakers; Image artefacts; Magnetic resonance imaging; Risk-benefit ratio; Radiology, Nuclear Medicine and Imaging
Settore MED/36 - Diagnostica per Immagini e Radioterapia
2018
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/572280
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