MRI in pediatric and congenital heart disease patients with CIEDs and epicardial or abandoned leads.

Autor: Gakenheimer-Smith L; Department of Pediatrics, University of Utah, Salt Lake City, Utah., Etheridge SP; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Niu MC; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Ou Z; Department of Pediatrics, University of Utah, Salt Lake City, Utah.; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah.; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah., Presson AP; Department of Pediatrics, University of Utah, Salt Lake City, Utah.; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah., Whitaker P; Primary Children's Hospital, Salt Lake City, Utah., Su J; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Puchalski MD; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Asaki SY; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Pilcher T; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Jazyk: angličtina
Zdroj: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2020 Aug; Vol. 43 (8), pp. 797-804. Date of Electronic Publication: 2020 Jul 06.
DOI: 10.1111/pace.13984
Abstrakt: Background: Heart Rhythm Society guidelines outlining magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices (CIEDs) excluded children and epicardial or abandoned leads due to theoretical risks of harm. Research investigating these risks is lacking. The primary objective of our study is to determine the incidence of adverse events to patients or CIEDs from MRI imaging. The secondary objective is to describe CIED-related artifact on MRI images.
Methods: A single-center retrospective review was performed on all patients with CIEDs who underwent 1.5 Tesla MRI between July 2007 and May 2019. We subdivided patients among four cohorts: (1) patients <18 years of age, (2) epicardial leads, (3) abandoned endocardial leads, and (4) abandoned epicardial leads. Descriptive statistics pre- and post-MRI and at follow-up within 1.5 years were conducted.
Results: Fifty-four MRIs were performed on 40 patients. Median age was 21.2 years (IQR 12.0-25.0). Eighteen (33%) MRIs contained abandoned leads; 20 (37%) contained epicardial leads. Three patients, one with abandoned epicardial leads and two with abandoned endocardial leads, experienced mild discomfort at the CIED site. One adult with endocardial leads experienced a pause in the heart rate while programmed in a nonpacing mode. No clinically important changes to CIED parameters occurred. Nine MRIs (17%), especially those with functional cardiac imaging, were uninterpretable due to image artifact.
Conclusion: In this study, pediatric and adult CHD patients with CIEDs, many with epicardial or abandoned leads, underwent MRIs without clinically significant complications. In some, CIED artifact reduced cardiac MRI image quality due to CIED position.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje