Multicenter retrospective evaluation of magnetic resonance imaging in pediatric and congenital heart disease patients with cardiac implantable electronic devices.

Autor:	Gakenheimer-Smith L; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah. Electronic address: lindsey.gakenheimer@hsc.utah.edu., Ou Z; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah., Kuang J; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Moore JP; Division of Cardiology, Department of Pediatrics, UCLA Medical Center, Los Angeles, California., Burrows A; Division of Cardiology, Department of Pediatrics, UCLA Medical Center, Los Angeles, California., Kovach J; Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin., Dechert B; Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan., Beach CM; Yale University School of Medicine, New Haven, Connecticut., Ayers M; Division of Pediatric Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana., Tan RB; Division of Pediatric Cardiology, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York., Mostafavifar M; Division of Pediatric Cardiology, OHSU, Portland, Oregon., Mah DY; Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts., Conner TM; Division of Pediatric Cardiology, Washington University in St. Louis, St. Louis, Missouri., Turpin S; UCSF Benioff Children's Hospital, Oakland, California., Avasarala K; UCSF Benioff Children's Hospital, Oakland, California., Shah MJ; Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania., Webster G; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois., Posey J; Children's Healthcare of Atlanta Cardiology, Atlanta, Georgia., Etheridge SP; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Binka E; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Niu M; 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., Lambert LM; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Pilcher TA; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2023 Dec; Vol. 20 (12), pp. 1752-1758. Date of Electronic Publication: 2023 Aug 28.
DOI:	10.1016/j.hrthm.2023.08.034
Abstrakt:	Background: Guidelines addressing magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices (CIEDs) provide algorithms for imaging pediatric and congenital heart disease (CHD) patients. Guideline acceptance varies by institution. Guidelines also do not support routine MRI scans in patients with epicardial or abandoned leads, common in pediatric and CHD patients. Objective: The purpose of this study was to determine the incidence of MRI-related complications in pediatric and CHD patients with CIEDs, including epicardial and/or abandoned leads. Methods: A multicenter retrospective review included patients with CIEDs who underwent any MRI between 2007 and 2022 at congenital cardiac centers. The primary outcome was any patient adverse event or clinically significant CIED change after MRI, defined as pacing lead capture threshold increase >0.5 V with output change, P- or R- wave amplitude decrease >50% with sensitivity change, or impedance change >50%. Results: Across 14 institutions, 314 patients (median age 18.8 [1.3; 31.4] years) underwent 389 MRIs. There were 288 pacemakers (74%) and 87 implantable cardioverter-defibrillators (22%); 52% contained epicardial leads, and 14 (4%) were abandoned leads only. Symptoms or CIED changes occurred in 4.9% of MRI scans (6.1% of patients). On 9 occasions (2%), warmth or pain occurred. Pacing capture threshold or lead impedance changes occurred in 1.4% and 2.0% of CIEDs post-MRI and at follow-up. Conclusion: Our data provide evidence that MRIs can be performed in pediatric and CHD patients with CIEDs, including non-MRI-conditional CIEDs and epicardial and/or abandoned leads, with rare minor symptoms or CIED changes but no other complications. (Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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