Access to magnetic resonance imaging of patients with magnetic resonance-conditional pacemaker and implantable cardioverter-defibrillator systems: results from the Really ProMRI study. Issue 6 (24th July 2017)

• Record Type: Journal Article
• Authors: Celentano, Eduardo; Caccavo, Vincenzo; Santamaria, Matteo; Baiocchi, Claudia; Melissano, Donato; Pisanò, Ennio; Gallo, Paolo; Polcino, Antonio; Arena, Giuseppe; Patanè, Santina; Senatore, Gaetano; Licciardello, Giovanni; Padeletti, Luigi; Vado, Antonello; Giorgi, Davide; Pecora, Domenico; Stella, Prospero; Anaclerio, Matteo; Guastaferro, Ciro; Giovannini, Tiziana; Giacopelli, Daniele; Gargaro, Alessio; Maglia, Giampiero
• Is Part Of: Europace. Volume 20:Issue 6(2018)
• Page Start: 1001
• Page End: 1009
• Publication Date: 2017-07-24
• Subjects: Magnetic resonance imaging -- Cardiac implantable electronic devices -- Pacemaker -- Implantable cardioverter-defibrillator -- MR-conditional devices; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/eux118
• Languages: English
• ISSNs: 1099-5129

Abstract

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.