Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing: Results of the Evera MRI Study

Autor: Béla Merkely, Michael R. Gold, Emanuel Kanal, Ralf Surber, Matthew A. Bernabei, Brian Ramza, Torsten Sommer, Jeffrey Cerkvenik, Juerg Schwitter, Charles J. Love
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Ventricular Tachyarrhythmias
Heart Ventricles
medicine.medical_treatment
Magnetic Resonance Imaging
Cine

030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Heart Conduction System
Physiology (medical)
Internal medicine
medicine
Humans
medicine.diagnostic_test
business.industry
Reproducibility of Results
Magnetic resonance imaging
Equipment Design
Middle Aged
medicine.disease
Implantable cardioverter-defibrillator
Defibrillators
Implantable

Induced ventricular tachycardia
Ventricular fibrillation
Tachycardia
Ventricular

Cardiology
Female
Medical emergency
Electrical conduction system of the heart
Cardiology and Cardiovascular Medicine
No detection
business
Follow-Up Studies
Zdroj: Heart Rhythm. 13:1631-1635
ISSN: 1547-5271
Popis: Background Studies have shown that magnetic resonance imaging (MRI) conditional pacemakers experience no significant effect from MRI on device function, sensing, or pacing. More recently, similar safety outcomes were demonstrated with MRI conditional defibrillators (implantable cardioverter-defibrillator [ICD]), but the impact on ventricular arrhythmias has not been assessed. Objective The purpose of this study was to assess the effect of MRI on ICD sensing and treatment of ventricular tachyarrhythmias. Methods The Evera MRI Study was a worldwide trial of 156 patients implanted with an ICD designed to be MRI conditional. Device-detected spontaneous and induced ventricular tachycardia/ventricular fibrillation (VT/VF) episodes occurring before and after whole body MRI were evaluated by a blinded episode review committee. Detection delay was computed as the sum of RR intervals of undersensed beats. A ≥5-second delay in detection due to undersensing was prospectively defined as clinically significant. Results Post-MRI, there were 22 polymorphic VT/VF episodes in 21 patients, with 16 of these patients having 17 VT/VF episodes pre-MRI. Therapy was successful for all episodes, with no failures to treat or terminate arrhythmias. The mean detection delay due to undersensing pre- and post-MRI was 0.60 ± 0.59 and 0.33 ± 0.63 seconds, respectively (P = .17). The maximum detection delay was 2.19 seconds pre-MRI and 2.87 seconds post-MRI. Of the 17 pre-MRI episodes, 14 (82%) had some detection delay as compared with 11 of 22 (50%) post-MRI episodes (P = .03); no detection delay was clinically significant. Conclusion Detection and treatment of VT/VF was excellent, with no detection delays or significant impact of MRI observed.
Databáze: OpenAIRE