Document Detail


Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environment.
MedLine Citation:
PMID:  20933098     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Magnetic resonance imaging (MRI) of pacemaker patients is contraindicated due to documented potential risks to the patient from hazardous interactions between the MRI and pacemaker system.
OBJECTIVE: The purpose of this prospective, randomized, controlled, worldwide clinical trial was to evaluate the safety and effectiveness of a pacemaker system designed for safe use in MRI for any bradycardia indicated patient.
METHODS: Patients (n = 464) were randomized to undergo an MRI scan between 9 and 12 weeks postimplant (MRI group, n = 258) or not to undergo MRI (control group, n = 206) after successful implantation of the specially designed dual-chamber pacemaker and leads. Patients were monitored for arrhythmias, symptoms, and pacemaker system function during 14 nonclinically indicated relevant brain and lumbar MRI sequences. Sequences were performed at 1.5 T and included scans with high radiofrequency power deposition and/or high gradient dB/dt exposure. Clinical evaluation of the pacemaker system function occurred immediately before and after MRI, 1 week and 1 month post-MRI, and at corresponding times for the control group. Primary endpoints for safety analyzed the MRI procedure complication-free rate and for effectiveness compared capture and sensing performance between MRI and control groups.
RESULTS: No MRI-related complications occurred during or after MRI, including sustained ventricular arrhythmias, pacemaker inhibition or output failures, electrical resets, or other pacemaker malfunctions. Pacing capture threshold and sensed electrogram amplitude changes were minimal and similar between study groups.
CONCLUSION: This trial documented the ability of this pacemaker system to be exposed in a controlled fashion to MRI in a 1.5 T scanner without adverse impact on patient outcomes or pacemaker system function.
Authors:
Bruce L Wilkoff; David Bello; Milos Taborsky; Josef Vymazal; Emanuel Kanal; Hubertus Heuer; Katrin Hecking; W Ben Johnson; William Young; Brian Ramza; Naveed Akhtar; Bernhard Kuepper; Peter Hunold; Roger Luechinger; Helmut Puererfellner; Firat Duru; M J W Gotte; Richard Sutton; Torsten Sommer;
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Publication Detail:
Type:  Journal Article     Date:  2010-10-07
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  8     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA. wilkofb@ccf.org
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Comment In:
Heart Rhythm. 2011 Jan;8(1):74-5   [PMID:  21044900 ]

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