[논문]Cardiac magnetic resonance imaging using wideband sequences in patients with nonconditional cardiac implanted electronic devices

Do, Duc H.; Eyvazian, Vaughn; Bayoneta, Aileen J.; Hu, Peng; Finn, J. Paul; Bradfield, Jason S.; Shivkumar, Kalyanam; Boyle, Noel G.

doi:10.1016/j.hrthm.2017.10.003

Cardiac magnetic resonance imaging using wideband sequences in patients with nonconditional cardiac implanted electronic devices 원문보기

Heart rhythm, v.15 no.2, 2018년, pp.218 - 225

Do, Duc H. (UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Eyvazian, Vaughn (UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Bayoneta, Aileen J. (UCLA Department of Radiology, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Hu, Peng (UCLA Department of Radiology, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Finn, J. Paul (UCLA Department of Radiology, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Bradfield, Jason S. (UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Shivkumar, Kalyanam (UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California) , Boyle, Noel G. (UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California)

Abstract ▼ AI-Helper

Background Magnetic resonance imaging (MRI) has been performed safely in patients without MRI-conditional cardiac implantable electronic devices (CIEDs), but experience specifically with cardiac magnetic resonance imaging (CMR) is limited in this patient population. Objective Evaluate the safety of CMR in non–MRI-conditional CIEDs and the interpretability of images using wideband sequences. Methods We performed 114 consecutive CMR studies in 111 patients (mean age 59 ± 14 years, with 12 pacemakers, 73 implantable cardioverter defibrillators, 29 biventricular defibrillators) using a wideband pulse sequence for late gadolinium enhancement (LGE) imaging. A standardized protocol for device management and patient monitoring was followed. Patients were evaluated for major clinical adverse events and device parameter changes immediately after CMR and at clinical follow-up. Results In total, 111 CMR studies were completed successfully. There were no patient deaths, new arrhythmias, immediate generator or lead failures, electrical resets, or pacing capture failures in dependent patients. Right atrial, right ventricular, and left ventricular lead impedances were significantly lower post CMR, with median differences −7 Ω (interquartile range [IQR] −20 to 0 Ω; P < .0001), 0 Ω (IQR −19 to 0 Ω; P = .0001), and −10 Ω (IQR −30 to 0 Ω; P = .023), respectively. These changes persisted through the follow-up period, with median differences −18.5 Ω (IQR −41 to −66 Ω; P = .007), −19 Ω (IQR −44 to −7 Ω; P = .006), and −30 Ω (IQR −130 to 0 Ω; P = .003), respectively. Ninety-seven studies (87%) had no artifact limiting interpretation. Conclusions CMR can be performed safely in non–MRI-conditional CIEDs using a standardized protocol. Use of a wideband pulse sequence for LGE imaging yields a high rate of studies unaffected by artifact.

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Cardiac magnetic resonance imaging using wideband sequences in patients with nonconditional cardiac implanted electronic devices 원문보기

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