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- Publisher Website: 10.1016/j.hrthm.2020.08.020
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- PMID: 32911050
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Article: Safety of magnetic resonance imaging scanning in patients with cardiac resynchronization therapy-defibrillators incorporating quadripolar left ventricular leads
Title | Safety of magnetic resonance imaging scanning in patients with cardiac resynchronization therapy-defibrillators incorporating quadripolar left ventricular leads |
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Authors | |
Keywords | Cardiac resynchronization therapy Implantable cardioverter-defibrillator Magnetic resonance imaging Quadripolar lead Ventricular fibrillation |
Issue Date | 2020 |
Publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal |
Citation | Heart Rhythm, 2020, v. 17 n. 12, p. 2064-2071 How to Cite? |
Abstract | Background:
Magnetic resonance imaging (MRI) scanning of magnetic resonance (MR)-conditional cardiac implantable cardioverter-defibrillators (ICDs) can be performed safely following specific protocols. MRI safety with cardiac resynchronization therapy–defibrillators (CRT-Ds) incorporating quadripolar left ventricular (LV) leads is less clear.
Objective:
The purpose of this study was to evaluate the safety and effectiveness of ICDs and CRT-D systems with quadripolar LV leads after an MRI scan.
Methods:
The ENABLE MRI Study included 230 subjects implanted with a Boston Scientific ImageReady ICD (n = 39) or CRT-D (n = 191) incorporating quadripolar LV leads undergoing nondiagnostic 1.5-T MRI scans (lumbar and thoracic spine imaging) a minimum of 6 weeks postimplant. Pacing capture thresholds (PCTs), sensing amplitudes (SAs), and impedances were measured before and 1 month post-MRI using the same programmed LV pacing vectors. The ability to sense/treat ventricular fibrillation (VF) was assessed in a subset of patients.
Results:
A total of 159 patients completed a protocol-required MRI scan (MRI Protection Mode turned on) with no scan-related complications. All right ventricular (RV) and left LV PCT and SA effectiveness endpoints were met: RV PCT 99% (145/146 patients), LV PCT 100% (120/120), RV SA 99% (145/146), and LV SA 98% (116/118). In no instances did MRI result in a change in pacing vector or lead revision. All episodes of VF were appropriately sensed and treated.
Conclusion:
This first evaluation of predominantly CRT-D systems with quadripolar LV leads undergoing 1.5-T MRI confirmed that scanning was safe with no significant changes in RV/LV PCT, SA, programmed vectors, and VF treatment, thus suggesting that MRI in patients having a device with quadripolar leads can be performed without negative impact on CRT delivery. |
Persistent Identifier | http://hdl.handle.net/10722/307615 |
ISSN | 2023 Impact Factor: 5.6 2023 SCImago Journal Rankings: 2.072 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Rinaldi, CA | - |
dc.contributor.author | Vitoff, PJ | - |
dc.contributor.author | Nair, DR | - |
dc.contributor.author | Bernstein, R | - |
dc.contributor.author | Mountantonakis, SE | - |
dc.contributor.author | Rapacciuolo, A | - |
dc.contributor.author | Carter, N | - |
dc.contributor.author | Tse, HF | - |
dc.contributor.author | Green, UB | - |
dc.date.accessioned | 2021-11-12T13:35:12Z | - |
dc.date.available | 2021-11-12T13:35:12Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Heart Rhythm, 2020, v. 17 n. 12, p. 2064-2071 | - |
dc.identifier.issn | 1547-5271 | - |
dc.identifier.uri | http://hdl.handle.net/10722/307615 | - |
dc.description.abstract | Background: Magnetic resonance imaging (MRI) scanning of magnetic resonance (MR)-conditional cardiac implantable cardioverter-defibrillators (ICDs) can be performed safely following specific protocols. MRI safety with cardiac resynchronization therapy–defibrillators (CRT-Ds) incorporating quadripolar left ventricular (LV) leads is less clear. Objective: The purpose of this study was to evaluate the safety and effectiveness of ICDs and CRT-D systems with quadripolar LV leads after an MRI scan. Methods: The ENABLE MRI Study included 230 subjects implanted with a Boston Scientific ImageReady ICD (n = 39) or CRT-D (n = 191) incorporating quadripolar LV leads undergoing nondiagnostic 1.5-T MRI scans (lumbar and thoracic spine imaging) a minimum of 6 weeks postimplant. Pacing capture thresholds (PCTs), sensing amplitudes (SAs), and impedances were measured before and 1 month post-MRI using the same programmed LV pacing vectors. The ability to sense/treat ventricular fibrillation (VF) was assessed in a subset of patients. Results: A total of 159 patients completed a protocol-required MRI scan (MRI Protection Mode turned on) with no scan-related complications. All right ventricular (RV) and left LV PCT and SA effectiveness endpoints were met: RV PCT 99% (145/146 patients), LV PCT 100% (120/120), RV SA 99% (145/146), and LV SA 98% (116/118). In no instances did MRI result in a change in pacing vector or lead revision. All episodes of VF were appropriately sensed and treated. Conclusion: This first evaluation of predominantly CRT-D systems with quadripolar LV leads undergoing 1.5-T MRI confirmed that scanning was safe with no significant changes in RV/LV PCT, SA, programmed vectors, and VF treatment, thus suggesting that MRI in patients having a device with quadripolar leads can be performed without negative impact on CRT delivery. | - |
dc.language | eng | - |
dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal | - |
dc.relation.ispartof | Heart Rhythm | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Cardiac resynchronization therapy | - |
dc.subject | Implantable cardioverter-defibrillator | - |
dc.subject | Magnetic resonance imaging | - |
dc.subject | Quadripolar lead | - |
dc.subject | Ventricular fibrillation | - |
dc.title | Safety of magnetic resonance imaging scanning in patients with cardiac resynchronization therapy-defibrillators incorporating quadripolar left ventricular leads | - |
dc.type | Article | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1016/j.hrthm.2020.08.020 | - |
dc.identifier.pmid | 32911050 | - |
dc.identifier.scopus | eid_2-s2.0-85093672750 | - |
dc.identifier.hkuros | 329276 | - |
dc.identifier.volume | 17 | - |
dc.identifier.issue | 12 | - |
dc.identifier.spage | 2064 | - |
dc.identifier.epage | 2071 | - |
dc.identifier.isi | WOS:000594819400006 | - |
dc.publisher.place | United States | - |