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Europace. 2018 Jun 1;20(6):1001-1009. doi: 10.1093/europace/eux118.

Access to magnetic resonance imaging of patients with magnetic resonance-conditional pacemaker and implantable cardioverter-defibrillator systems: results from the Really ProMRI study.

Author information

1
Fondazione Cardimed and C.D.C. I.O.S. MF Group, Pomigliano d'Arco.
2
Ospedale E.E. Miulli - Acquaviva delle Fonti, Bari.
3
Fondazione G. Paolo II, Campobasso.
4
Policlinico Le Scotte, Siena.
5
P.O. F.Ferrari, Casarano, Lecce.
6
P.O. Vito Fazzi, Lecce.
7
C.D.C. Villa dei Fiori, Acerra, Napoli.
8
A.O. G. Rummo, Benevento.
9
Nuovo Ospedale Apuano Marina, Massa.
10
A.O.O.R. Papardo Piemonte, P.O. Papardo, Messina.
11
Ospedale di Ciriè, Ciriè, Torino.
12
P.O. Muscatello, Augusta, Siracusa.
13
A.O.U. Careggi, Firenze.
14
Ospedale S. Croce e Carlo, Cuneo.
15
Ospedale Campo di Marte, Lucca.
16
Fondazione Poliambulanza, Brescia.
17
Ospedale Santa Maria della Misericordia, Sorrento, Napoli.
18
Policlinico Consorziale, Bari.
19
OO.RR. Area Stabiese, Castellammare di Stabia, Napoli.
20
Nuovo Ospedale di Prato, Prato.
21
BIOTRONIK Italia S.p.A., Milano.
22
A.O. Pugliese Ciaccio, Catanzaro.

Abstract

Aims:

The Really ProMRI study evaluates magnetic resonance imaging (MRI) access for patients with cardiac implantable electronic devices (CIEDs) as well as the performance of magnetic resonance (MR)-conditional leads when undergoing MRI.

Methods and results:

Patients either with an MR-conditional pacemaker or implantable defibrillator (ICD) system or with at least a component (device or one or more leads) from an MR-conditional system, were asked to fill in a questionnaire when they were referred to a MR scan. The rate of prescription, denial, or execution of MR examinations was evaluated in a 1-year follow-up visit. In total, 555 patients [median age (interquartile range) 72.2 (62.2-78.6); 72% male] were enrolled, 49% (270) with a pacemaker, 51% (285) with an ICD system. Five-hundred and ten patients completed the follow-up period. A total of 37 MRI referrals were reported in 35 patients, with a consequent event rate of 7.0/100 patient-years (CI, 4.9-9.7). Fourteen were denied, while 23 [66%; (CI, 48-81%)] were performed. The number of patients with MR referrals was not statistically different between pacemaker and ICD groups (21 vs. 14; P = 0.178). The rate of scans performed was higher in the pacemaker subjects (19/23 vs. 4/14, P = 0.003), while it was similar between patients with or without a complete MR-conditional system (19/30 vs. 4/7, P = 0.606).

Conclusion:

In this study, we reported a 7.0/100 patient-year's event rate of MR prescriptions in CIED patients. Many examinations were denied, despite MR-conditional systems, especially in ICD patients. Regulatory and cultural changes are needed to allow wider access to MR imaging in CIED patients with MR-conditional systems.

PMID:
29016759
DOI:
10.1093/europace/eux118
[Indexed for MEDLINE]

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