Real-World Evaluation of Magnetic Resonance Imaging in Patients With a Magnetic Resonance Imaging Conditional Pacemaker System: Results of 4-Year Prospective Follow-Up in 2,629 Patients.

Autor:	Williamson BD; Beaumont Health System, Troy and Royal Oak, Michigan. Electronic address: brian.williamson@beaumont.edu., Gohn DC; Lancaster General Health, Lancaster, Pennsylvania., Ramza BM; Saint Luke's Mid America Heart Institute, Kansas City, Missouri., Singh B; Medanta-The Medicity, Gurgaon, Haryana, India., Zhong Y; Medtronic PLC, Minneapolis, Minnesota., Li S; Medtronic PLC, Minneapolis, Minnesota., Shanahan L; Medtronic PLC, Minneapolis, Minnesota.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2017 Nov; Vol. 3 (11), pp. 1231-1239. Date of Electronic Publication: 2017 Sep 13.
DOI:	10.1016/j.jacep.2017.05.011
Abstrakt:	Objectives: This global, multicenter, prospective study, initiated to meet U.S. Food and Drug Administration condition-of-approval requirements, evaluated the safety and efficacy of the Medtronic magnetic resonance imaging (MRI)-conditional pacing system when used in an MRI environment in routine clinical practice. The primary endpoint was MRI-related complications. The secondary endpoint was the cumulative change in pacing capture threshold (PCT) for patients undergoing multiple MRI scans. Background: Large-scale, real-world evaluation of MRI in patients implanted with an MRI-conditional pacing system remains limited, with few published data for patients who undergo multiple MRI scans. Methods: Patients were enrolled and followed up prospectively from the time of implantation. Evaluation of the pacemaker function was performed before and after MRI. The MRI-related complication-free rate was evaluated. Changes in electrical performance after each scan and cumulative changes over multiple scans were analyzed. Results: In 81 centers, 2,629 patients were implanted with a complete SureScan pacing system (41.8% women, age 70.2 ± 12.5 years). A total of 526 patients (28.5%) received 872 clinically indicated MRI scans, including 58 thoracic scans. No MRI-related complications occurred during or after MRI, meeting the primary objective. Six (1%) MRI-related observations (atrial fibrillation, PCT increase, and chest symptoms) were reported. A total of 171 patients (32.5%) underwent 2 or more scans with no cumulative increase in PCT. Conclusions: This report constitutes the largest longitudinal MRI experience in patients implanted with an MRI-conditional pacing system. Results support the safety profile of the SureScan system and demonstrate for the first time that patients may safely undergo multiple MRI scans. (SureScan Post-Approval Study; NCT01299675). (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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