Articles de revues : « MR-conditional device »

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Seewöster, Timm, Susanne Löbe, Sebastian Hilbert, Andreas Bollmann, Philipp Sommer, Frank Lindemann, Justinas Bacevičius et al. « Cardiovascular magnetic resonance imaging in patients with cardiac implantable electronic devices : best practice and real-world experience ». EP Europace 21, n^o 8 (25 mai 2019) : 1220–28. http://dx.doi.org/10.1093/europace/euz112.

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Abstract Aims Cardiovascular magnetic resonance (CMR) imaging has long been a contraindication for patients with a cardiac implantable electronic device (CIED). Recent studies support the feasibility and safety for non-thoracic magnetic resonance imaging, but data for CMR are sparse. The aim of the current study was to determine the safety in patients with magnetic resonance (MR)-conditional or non-MR-conditional CIED and to develop a best practice approach. Methods and results All patients with a CIED undergoing CMR imaging (1.5 T) between April 2014 and April 2017 were included in the study. Devices were programmed according to the standardized protocol directly before and after the CMR examination. Follow-up interrogation was performed 6 months after CMR examination. Results were compared with a large, reference cohort of CIED patients not undergoing any MR examination. A total of 200 consecutive patients with a CIED (non-MR-conditional, n = 103) were included in the study. Directly after CMR imaging, one device failure (0.5%, battery status = end of service) was noted necessitating premature generator replacement. In three patients (2%) of pacemaker/implantable cardioverter-defibrillator (ICD) carriers a sustained ventricular tachycardia (VT) occurred during CMR imaging. Ten ICD showed a decrease in battery capacity immediately after CMR. Overall, the reference cohort showed comparable changes of CIED function during follow-up. Conclusion With adherence to a standardized protocol and established exclusion criteria CMR imaging could safely be performed in patients with a CIED. The potential risks of device malfunction necessitate the presence of a device trained individual during the entire CMR examination. If there is a history of VT storm the attendance of an experienced cardiologist, should be mandatory.

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Wineland, Adam, Yue Chen, Brian Boland, Kevin Chan et Zion Tse. « Magnetic Resonance Conditional Microinjector ». Journal of Imaging 5, n^o 1 (30 décembre 2018) : 4. http://dx.doi.org/10.3390/jimaging5010004.

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Glaucoma, one of the leading causes of blindness, has been linked to increases in intraocular pressure. In order to observe and study this effect, proposed is a specialized microinjector and driver that can be used to inject small amounts of liquid into a target volume. Magnetic resonance imaging (MRI) guided remotely activated devices require specialized equipment that is compatible with the MR environment. This paper presents an MR Conditional microinjector system with a pressure sensor for investigating the effects of intraocular pressure (IOP) in near-real-time. The system uses pressurized air and a linear actuation device to push a syringe in a controlled, stepwise manner. The feasibility and utility of the proposed investigative medical research tool were tested and validated by measuring the pressure inside an intact animal donor eyeball while precise, small volumes of water were injected into the specimen. Observable increases in the volume of the specimen at measured, specific target pressure increases show that the system is technically feasible for studying IOP effects, while the changes in shape were depicted in MRI scan images themselves. In addition, it was verified that the presence and operation of the system did not interfere with the MRI machine, confirming its conditional compatibility with the 3T MRI.

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GODEC, Matic, Jani IZLAKAR et Gašper PODOBNIK. « MRI SAFETY AND MANAGEMENT OF PATIENTS WITH CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICES : LITERATURE REVIEW AND CASE PRESENTATION ». MEDICAL IMAGING AND RADIOTHERAPY JOURNAL 38, n^o 2 (17 décembre 2022) : 15–21. http://dx.doi.org/10.47724/mirtj.2021.i02.a002.

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Introduction: MRI has long been contraindicated in patients with CIED devices due to the risk of adverse eff ects through electromagnetic interference. Recent developments in engineering have led to the introduction of MRI conditional CIED devices that do not cause signifi cant clinical harm to patients undergoing MRI, when specifi c imaging conditions are met. Safe access to MRI has become a crucial need for patients with CIED devices. Aim: The purpose of this paper is to present an overview of how to manage patients with implanted CIED devices and to present a case report of a patient with CIED undergoing prostate MRI examination. Methods: This paper explores MRI Safety and the management of patients with implanted CIED devices through an extensive literature review and case presentation. The literature search was conducted using medical scientifi c electronic databases such as PubMed, Cinahl, Wiley Online Library and ScienceDirect. We examined a patient with a CIED device undergoing a prostate MRI examination. Results and discussion: We performed an examination of the described patient in accordance to the guidelines presented in this paper. The MR conditionality status was determined using the device identifi cation card and the manufacturer’s technical manual. The MRI examination of the patient was completed without complications; therefore, no adverse eff ects were reported. The MRI images were without artefacts. Conclusion: Recent clinical studies and published guidelines suggest that MRI of the patients with either an MRI conditional or MRI non-conditional CIED device is relatively safe under specifi c conditions. Multidisciplinary pre-procedure planning, a strict screening process, monitoring and device evaluation protocols are of key importance for ensuring safe MRI imaging in patients with CIED.

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Ryan, James W., Aoife S. Murray, Paddy J. Gilligan, James M. Bisset, Chris Nolan, Audrey Doyle, Barry Emerson, Joseph M. Galvin et John G. Murray. « MRI safety management in patients with cardiac implantable electronic devices : Utilizing failure mode and effects analysis for risk optimization ». International Journal for Quality in Health Care 32, n^o 7 (août 2020) : 431–37. http://dx.doi.org/10.1093/intqhc/mzaa067.

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Abstract Introduction Cardiac implantable electronic devices (CIEDs) are increasing in prevalence. Exposing patients with CIEDs to magnetic resonance imaging (MRI) can lead to adverse outcomes. This has led certain radiology departments to not accept MRI referrals related to patients with CIEDs. Patients with MR-conditional CIEDs can be safely scanned under specific conditions. Our institution has accepted such referrals since 2014. The aim of this study was to systematically identify and reduce risk in our CIED-MRI protocol using failure mode and effects analysis (FMEA). Methods A multidisciplinary FMEA team was assembled and included senior stakeholders from the CIED-MRI protocol. A process map was constructed followed by risk analysis and scoring. Targeted interventions were formulated and implemented; high-risk failure modes were prioritized. A new process map and protocol were drafted and repeat risk analysis was performed. Monitoring and re-evaluation of the CIED-MRI pathway were instigated at departmental quality assurance (QA) meetings. Results Interventions included direct CIED characterization using wireless technology pre-MRI, CIED programming and reprogramming in the MRI suite before and immediately after MRI reducing device downtime and continuous patient monitoring during MRI by a cardiac physiologist. The cumulative risk priority number (RPN) decreased from 1190 pre-FMEA to 492 post-FMEA. Discussion Despite the risk of exposing CIEDs to the MR environment, patients with MR-conditional CIEDs can be safely scanned with an appropriate multidisciplinary support. We found FMEA an indispensable tool in identifying and minimizing risk with no adverse events recorded since FMEA recommendations were implemented.

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Munawar, Dian A., Joel E. Z. Chan, Mehrdad Emami, Kadhim Kadhim, Kashif Khokhar, Catherine O’Shea, Shinsuke Iwai et al. « Magnetic resonance imaging in non-conditional pacemakers and implantable cardioverter-defibrillators : a systematic review and meta-analysis ». EP Europace 22, n^o 2 (30 janvier 2020) : 288–98. http://dx.doi.org/10.1093/europace/euz343.

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Abstract Aims There is growing evidence that magnetic resonance imaging (MRI) scanning in patients with non-conditional cardiac implantable electronic devices (CIEDs) can be performed safely. Here, we aim to assess the safety of MRI in patients with non-conditional CIEDs. Methods and results English scientific literature was searched using PubMed/Embase/CINAHL with keywords of ‘magnetic resonance imaging’, ‘pacemaker’, ‘implantable defibrillator’, and ‘cardiac resynchronization therapy’. Studies assessing outcomes of adverse events or significant changes in CIED parameters after MRI scanning in patients with non-conditional CIEDs were included. References were excluded if the MRI conditionality of the CIEDs was undisclosed; number of patients enrolled was <10; or studies were case reports/series. 35 cohort studies with a total of 5625 patients and 7196 MRI scans (0.5–3 T) in non-conditional CIEDs were included. The overall incidence of lead failure, electrical reset, arrhythmia, inappropriate pacing and symptoms related to pocket heating, or torque ranged between 0% and 1.43%. Increase in pacing lead threshold >0.5 V and impedance >50Ω was seen in 1.1% [95% confidence interval (CI) 0.7–1.8%] and 4.8% (95% CI 3.3–6.4%) respectively. The incidence of reduction in P- and R-wave sensing by >50% was 1.5% (95% CI 0.6–2.9%) and 0.4% (95% CI 0.06–1.1%), respectively. Battery voltage reduction of >0.04 V was reported in 2.2% (95% CI 0.2–6.1%). Conclusion This meta-analysis affirms the safety of MR imaging in non-conditional CIEDs with no death or implantable cardioverter-defibrillator shocks and extremely low incidence of lead or device-related complications.

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Elmouchi, Darryl A., Nagib Chalfoun et Andre Gauri. « Attitudes of Implanting Physicians about Cardiac Rhythm Management Devices and Their Features ». ISRN Cardiology 2013 (26 décembre 2013) : 1–6. http://dx.doi.org/10.1155/2013/247586.

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Modern cardiac rhythm management systems have become increasingly complex. The decision on which specific system to implant in a given patient often rests with the implanting physician. We conducted a multiple-choice survey to assess the opinions and preferences of cardiologists and electrophysiologists who implant and follow cardiac rhythm management systems. Reliability and battery longevity were viewed as the most important characteristics in device selection. Patient characteristics which most affected device choice were pacing indication and life expectancy. Remote technology was used in 47% of pacemaker patients, 64% of ICD patients, and 65% of CRT-D patients, with wireless (radiofrequency) remote patient monitoring associated with higher patient compliance rates (74% versus 64%, resp.). Wireless remote patient management with alerts for atrial tachyarrhythmias was felt to be important by 76% of respondents. When choosing an MR-conditional device, physicians deemed patients with prior orthopedic problems, a history of cancer, or neurological disorders to be more likely to require a future MRI. Device longevity and reliability remain the most important factors which influence device selection. Wireless remote patient monitoring with alerts is considered increasingly important when choosing a specific cardiac rhythm management system to implant.

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Savouré, Arnaud, Alexis Mechulan, Marc Burban, Audrey Olivier et Arnaud Lazarus. « The Kora Pacemaker is Safe and Effective for Magnetic Resonance Imaging ». Clinical Medicine Insights : Cardiology 9 (janvier 2015) : CMC.S24976. http://dx.doi.org/10.4137/cmc.s24976.

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Background The impact of magnetic resonance imaging (MRI) on pacemakers is potentially hazardous. We present clinical results from a novel MRI conditional pacing system with the capability to switch automatically to asynchronous mode in the presence of a strong magnetic field. Aims The IKONE ( Assessment of the MRI solution: KORA 100™ and Beflex™ pacing leads system) study is an open-label, prospective, multicenter study aimed at confirming the safety and effectiveness of the system, when used in patients undergoing MRI of anatomical regions excluding the chest. Methods Primary eligibility criteria included patients implanted with the system, with or without a clinically indicated MRI. The primary endpoint was to confirm no significant change in pacing capture thresholds at 1 month after an MRI, with an absolute difference of ≤0.75 V between the pre- and 1-month post-MRI for both atrial and ventricular capture thresholds. Results Out of 33 patients enrolled (mean age: 72.8 ± 11.4 years, 70% male, implant indication or device), 29 patients implanted with the MRI conditional system underwent an MRI 6-8 week postimplant. The study reached its primary endpoint: the mean absolute difference in pacing capture threshold at 1-month post-MRI versus pre-MRI was less than 0.75 V in the atrium (Δ = 0.18 ± 0.16 V, P-value <0.001) and in the ventricle (Δ = 0.18 ± 0.22 V, P-value <0.001). There were no adverse events related to the MRI procedure nor were there reports of patient symptoms or discomfort associated. MR image quality was of diagnostic quality in all patients. Conclusion Lead electrical performance as measured by difference in capture thresholds were not impacted by MRI. This first clinical evaluation of a novel MRI conditional system demonstrates it is safe and effective for use in out-of-chest, 1.5-T MR imaging.

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Boarescu, Paul-Mihai, Iulia Diana Popa, Cătălin Aurelian Trifan, Adela Nicoleta Roşian et Ştefan Horia Roşian. « Practical Approaches to Transvenous Lead Extraction Procedures—Clinical Case Series ». International Journal of Environmental Research and Public Health 20, n^o 1 (26 décembre 2022) : 379. http://dx.doi.org/10.3390/ijerph20010379.

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Transvenous lead extraction (TLE) is regarded as the first-line strategy for the management of complications associated with cardiac implantable electronic devices (CIEDs), when lead removal is mandatory. The decision to perform a lead extraction should take into consideration not only the strength of the clinical indication for the procedure but also many other factors such as risks versus benefits, extractor and team experience, and even patient preference. TLE is a procedure with a possible high risk of complications. In this paper, we present three clinical cases of patients who presented different indications of TLE and explain how the procedures were successfully performed. In the first clinical case, TLE was necessary because of device extravasation and suspicion of CIED pocket infection. In the second clinical case, TLE was necessary because occlusion of the left subclavian vein was found when an upgrade to cardiac resynchronization therapy was performed. In the last clinical case, TLE was necessary in order to remove magnetic resonance (MR) non-conditional leads, so the patient could undergo an MRI examination for the management of a brain tumor.

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Zbinden, Rainer, Christian Wollmann, Johannes Brachmann, Jochen Michaelsen, Clemens Steinwender, Pramesh Kovoor, Sebastian Kelle et al. « Clinical safety of the ProMRI implantable cardioverter-defibrillator systems during head and lower lumbar magnetic resonance imaging at 3 T : results of the ProMRI 3T ENHANCED Master study ». EP Europace 21, n^o 11 (19 juillet 2019) : 1678–85. http://dx.doi.org/10.1093/europace/euz189.

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Abstract Aims There have been no published studies on the safety of magnetic resonance imaging (MRI) at 3 Tesla (3 T) in patients with MRI-conditional implantable cardioverter-defibrillators (ICDs). The aim of this study was to assess clinical safety of the Biotronik ProMRI ICD system during non-diagnostic head and lower lumbar scans under 3 T MRI conditions. Methods and results The study enrolled 129 patients at 12 sites in Australia, Singapore, and Europe. Predefined head and lower lumbar MR scans (total duration ≈30 min) were performed in 112 patients. Three primary endpoints were evaluated from the pre-MRI to the 1-month post-MRI visit: (i) freedom from serious adverse device effects (SADEs) related to MRI (hypothesized to be >90%); (ii) pacing threshold invariance for all leads (geometric mean of the patient-wise ratios for 1 month vs. pre-MRI was hypothesized to be <1.07); and (iii) sensing amplitude invariance (geometric mean of the ratios was hypothesized to be >0.993). No MRI-related SADE occurred (SADE-free rate 100%, 95% confidence interval 95.98–100%). Pacing threshold and sensing amplitudes fulfilled the invariance hypotheses with high statistical significance (P < 0.0013). No threshold increase >0.5 V or sensing amplitude decrease by >50% was observed (secondary endpoints). Lead impedances, battery capacity, and detection and treatment of arrhythmias by ICDs were not affected by MRI scans. Conclusion The head and lower lumbar scans under specific 3 T MRI conditions were safe in the investigated MR-conditional ICD systems. There was no evidence of harm to the patients or any negative influence of the MRI scan on the implanted systems.

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Brown, M. S. « Regarding Off-Label Scanning of MR Conditional Devices ». American Journal of Neuroradiology 37, n^o 11 (18 août 2016) : 2001–2. http://dx.doi.org/10.3174/ajnr.a4932.

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Lad, Shivanand P. « Increasing Rates of Imaging in Failed Back Surgery Syndrome Patients : Implications for Spinal Cord Stimulation ». september 2017 6, n^o 20;6 (11 septembre 2017) : E969—E977. http://dx.doi.org/10.36076/ppj.20.5.e969.

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Background: Failed back surgery syndrome (FBSS) has a high incidence following spinal surgery, is notoriously refractory to treatment, and results in high health care utilization. Spinal cord stimulation (SCS) is a well-accepted modality for pain relief in this population; however, until recently magnetic resonance imaging (MRI) was prohibited due to risk of heat conduction through the device. Objectives: We examined trends in imaging use over the past decade in patients with FBSS to determine its impact on health care utilization and implications for patients receiving SCS. Study Design: Retrospective. Setting: Inpatient and outpatient sample. Methods: We identified patients from 2000 to 2012 using the Truven MarketScan database. Annual imaging rates (episodes per 1000 patient months) were determined for MRI, computed tomography (CT) scan, x-ray, and ultrasound. A multivariate Poisson regression model was used to determine imaging trends over time, and to compare imaging in SCS and non-SCS populations. Results: A total of 311,730 patients with FBSS were identified, of which 5.17% underwent SCS implantation (n = 16,118). The median (IQR) age was 58.0 (49.0 – 67.0) years. Significant increases in imaging rate ratios were found in all years for each of the modalities. Increases were seen in the use of CT scans (rate ratio [RR] = 3.03; 95% confidence interval [CI]: 2.79 – 3.29; P < 0.0001), MRI (RR = 1.73; 95% CI: 1.61 – 1.85; P < 0.0001), ultrasound (RR = 2.00; 95% CI: 1.84 – 2.18; P < 0.0001), and x-ray (RR = 1.10; 95% CI: 1.05 – 1.15; P < 0.0001). Despite rates of MRI in SCS patients being half that in the non-SCS group, these patients underwent 19% more imaging procedures overall (P < 0.0001). SCS patients had increased rates of x-ray (RR = 1.27; 95% CI: 1.25 – 1.29), CT scans (RR = 1.32; 95% CI: 1.30 – 1.35), and ultrasound (RR = 1.10; 95% CI: 1.07 – 1.13) (all P < 0.0001). Limitations: This study is limited by a lack of clinical and historical variables including the complexity of prior surgeries and pain symptomatology. Miscoding cannot be precluded, as this sample is taken from a large nationwide database. Conclusions: We found a significant trend for increased use of advanced imaging modalities between the years 2000 and 2012 in FBSS patients. Those patients treated with SCS were 50% less likely to receive an MRI (as expected, given prior incompatibility of neuromodulation devices), yet 32% and 27% more likely to receive CT and x-ray, respectively. Despite the decrease in the use of MRI in those patients treated with SCS, their overall imaging rate increased by 19% compared to patients without SCS. This underscores the utility of MR-conditional SCS systems. These findings demonstrate that imaging plays a significant role in driving health care expenditures. This is the largest analysis examining the role of imaging in the FBSS population and the impact of SCS procedures. Further studies are needed to assess the impact of MRI-conditional SCS systems on future trends in imaging in FBSS patients receiving neuromodulation therapies.

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Al-Dayeh, Louai, Mizan Rahman et Ross Venook. « Practical Aspects of MR Imaging Safety Test Methods for MR Conditional Active Implantable Medical Devices ». Magnetic Resonance Imaging Clinics of North America 28, n^o 4 (novembre 2020) : 559–71. http://dx.doi.org/10.1016/j.mric.2020.07.008.

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Pieri, Christopher, Anish Bhuva, Russell Moralee, Aderonke Abiodun, Deepa Gopalan, Giles H. Roditi, James C. Moon et Charlotte Manisty. « Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators ». Open Heart 8, n^o 1 (mai 2021) : e001598. http://dx.doi.org/10.1136/openhrt-2021-001598.

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ObjectiveTo determine provision of MRI for patients with cardiac implantable electronic devices (CIEDs; pacemakers and defibrillators) in England, to understand regional variation and assess the impact of guideline changes.MethodsRetrospective data related to MRI scans performed in patients with CIED over the preceding 12 months was collected using a structured survey tool distributed to every National Health Service Trust MRI unit in England. Data were compared with similar data from 2014/2015 and with demand (estimated from local CIED implantation rates and regional population data by sustainability and transformation partnerships (STPs)).ResultsResponses were received from 212 of 223 (95%) hospitals in England. 112 (53%) MRI units’ scan patients with MR-conditional CIEDs (10% also scan non-MR conditional devices), compared with 46% of sites in 2014/2015. Total annual scan volume increased over fourfold between 2014 and 2019 (1090 to 4896 scans). There was widespread geographical variation, with five STPs (total population >3·5 million representing approximately 25 000 patients with CIED) with no local provision. There was no correlation between local demand (CIED implantation rates) and MRI provision (scan volume). Complication rates were extremely low with three events nationally in 12 months (0·06% CIED–MRI scans).ConclusionsProvision of MRI for patients with CIEDs in England increased over fourfold in 4 years, but an estimated 10-fold care gap remains. Almost half of hospitals and 1 in 10 STPs have no service, with no relationship between local supply and demand. Availability of MRI for patients with non-MR conditional devices, although demonstrably safe, remains limited.

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Win, K., M. Stokes, K. Williams, B. Pitman, D. Scherer, K. Roberts-Thomson, P. Sanders et K. Teo. « Cardiac Magnetic Resonance (CMR) Image Quality in Implantable MR-Conditional Cardiac Devices ». Heart, Lung and Circulation 31 (2022) : S151. http://dx.doi.org/10.1016/j.hlc.2022.06.231.

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Gimbel, J. Rod. « The need for MR conditional devices : a sand castle at the seashore ? » Heart Rhythm 14, n^o 8 (août 2017) : 1145–46. http://dx.doi.org/10.1016/j.hrthm.2017.04.033.

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MIO, Motohira, Shinichi KATO, Naoko FUJITA, Asami OBATA, Eriko KOGA, Yuna KAWAHARA et Takumi HIRATA. « Beware of the Time-varying Magnetic Field during MRI Examinations for Patients with MR Conditional Implanted Medical Devices ». Japanese Journal of Magnetic Resonance in Medicine 39, n^o 1 (15 février 2019) : 15–17. http://dx.doi.org/10.2463/jjmrm.2018-1653.

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Ramirez-Suarez, Karen I., Hansel J. Otero, David M. Biko, Yoav Dori, Christopher L. Smith, Chris Feudtner et Ammie M. White. « Magnetic resonance lymphangiography in post-Fontan palliation patients with MR non-conditional cardiac electronic devices : An institutional experience ». Clinical Imaging 86 (juin 2022) : 43–52. http://dx.doi.org/10.1016/j.clinimag.2022.02.016.

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Baritussio, A., E. De Garate, A. Ghosh Dastidar, N. Ahmed, A. Scatteia, J. Rodrigues, C. Lawton et al. « 2 Clinical application of cardiovascular magnetic resonance in patients with MR-conditional devices : safety, feasibility and clinical impact ». Heart 102, Suppl 3 (18 avril 2016) : A1.2—A2. http://dx.doi.org/10.1136/heartjnl-2016-309668.2.

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Addevico, Francesco, Alberto Simoncini, Giovanni Solitro et Massimo Max Morandi. « Magnetic Resonance Imaging of the Knee in the Presence of Bridging External Fixation : A Comparative Experimental Evaluation of Four External Fixators, Including Dolphix® ». Journal of Functional Morphology and Kinesiology 7, n^o 1 (30 décembre 2021) : 4. http://dx.doi.org/10.3390/jfmk7010004.

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Performing MR investigation on patients instrumented with external fixators is still controversial. The aim of this study is to evaluate the quality of MR imaging of the knee structures in the presence of bridging external fixators. Different cadaveric lower limbs were instrumented with the MR-conditional external fixators Hofmann III (Stryker, Kalamazoo, MI, USA), Large external Fixator (DePuy Synthes, Raynham, MA, USA), XtraFix (Zymmer, Warsaw, IN, USA) and a newer implant of Ketron Peek CA30 and ERGAL 7075 pins, Dolphix®, (Citieffe, Bologna, Italy). The specimens were MR scanned before and after the instrumentation. The images were subjectively judged by a pool of blinded radiologists and then quantitatively evaluated calculating signal intensity, signal to noise and contrast to noise in the five regions of interest. The area of distortion due to the presence of metallic pins was calculated. All the images were considered equally useful for diagnosis with no differences between devices (p > 0.05). Only few differences in the quantification of images have been detected between groups while the presence of metallic components was the main limit of the procedure. The mean length of the radius of the area of distortion of the pins were 53.17 ± 8.19 mm, 45.07 ± 4.33 mm, 17 ± 5.4 mm and 37.12 ± 10.17 mm per pins provided by Zimmer, Synthes, Citieffe and Stryker, respectively (p = 0.041). The implant of Ketron Peek CA30 and ERGAL 7075 pins showed the smallest distortion area.

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Newcombe, Virginia F. J., Robert C. Hawkes, Sally G. Harding, Roslyn Willcox, Sarah Brock, Peter J. Hutchinson, David K. Menon, T. Adrian Carpenter et Jonathan P. Coles. « Potential heating caused by intraparenchymal intracranial pressure transducers in a 3-tesla magnetic resonance imaging system using a body radiofrequency resonator : assessment of the Codman MicroSensor Transducer ». Journal of Neurosurgery 109, n^o 1 (juillet 2008) : 159–64. http://dx.doi.org/10.3171/jns/2008/109/7/0159.

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Magnetic resonance imaging and spectroscopy may provide important clinical information in the acute stages of brain injury. For this to occur it must be ensured that intracranial pressure (ICP) monitoring devices are safe to bring into the MR imaging suite. The authors tested a Codman MicroSensor ICP Transducer (Codman & Shurtleff, Inc.) within a 3-T MR imaging system using the transmit body coil and receive-only coils and the transmit-and-receive head coil. Extreme and rapid heating of 64°C was noted with the transducer wire in certain positions when using the transmit body coil and receive-only head coil. This is consistent with the phenomenon of resonance, and the probe was shown to have a distinct resonant response when coupled to HP 4195A Network Analyzer (Hewlett Packard). Coiling some of the transducer wire outside of the receive-only head coil reduced the generated current and so stopped the thermogenesis. This may be due to the introduction of a radiofrequency choke. The ICP transducer performed within clinically acceptable limits in both the static magnetic field and during imaging with high radiofrequency power when the excess wire was in this configuration. No heating was observed when a transmit-and-receive head coil was used. This study has shown when using a high-field magnet, the Codman ICP probe is MR conditional. That is, in the authors' system, it can be safely used with the transmit-and-receive head coil, but when using the transmit body coil the transducer wire must be coiled into concentric loops outside of the receive-only head coil.

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Yang, Bin, Ka Keung Tang, Chen-Yu Huang, Hui Geng, Wai Wang Lam, Yeung Sum Wong, Mei Yan Tse, Ka Ki Lau, Kin Yin Cheung et Siu Ki Yu. « Out-of-field dose and its constituent components for a 1.5 T MR-Linac ». Physics in Medicine & ; Biology 66, n^o 22 (15 novembre 2021) : 225012. http://dx.doi.org/10.1088/1361-6560/ac3346.

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Abstract This study aims to quantify the relative contributions of phantom scatter, collimator scatter and head leakage to the out-of-field doses (OFDs) of both static fields and clinical intensity-modulated radiation therapy (IMRT) treatments in a 1.5 T MR-Linac. The OFDs of static fields were measured at increasing distances from the field edge in an MR-conditional water phantom. Inline scans at depths of dmax (14 mm), 50 and 100 mm were performed for static fields of 5 × 5, 10 × 10 and 15 × 15 cm2 under three different conditions: full scatter, with phantom scatter prevented, and head leakage only. Crossline scans at isocenter and offset positions were performed in full scatter condition. EBT3 radiochromic films were placed at 100 mm depth of solid water phantom to measure the OFD of clinical IMRT plans. All water tank data were normalized to Dmax of a 10 × 10 cm2 field and the film results were presented as a fraction of the target mean dose. The OFD in the inline direction varied from 3.5% (15 × 15 cm2, 100 mm depth, 50 mm distance) to 0.014% (5 × 5 cm2, dmax, 400 mm distance). For all static fields, the collimator scatter was higher than the phantom scatter and head leakage at a distance of 100–400 mm. Head leakage remained the smallest among the three components, except at long distances (>375 mm) with small field size. Compared to the inline scans, the crossline scans at the isocenter showed higher doses at distances longer than 80 mm. All crossline profiles at longitudinal offset positions showed a cone shape with laterally shifted maxima. The OFD of IMRT deliveries varied with different target size. For prostate stereotactic body radiation therapy (SBRT) treatment, the OFD decreased from 2% to 0.03% at a distance of 50–500 mm. The OFDs have been measured for a 1.5 T MR-Linac. The presented dosimetric data are valuable for radiation safety assessments on patients treated with the MR-Linac, such as evaluating carcinogenic risk and radiation exposure to cardiac implantable electronic devices.

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Desai, Mehul J., et Yair Safriel. « Shared Decision-Making : Evaluating the Evidence for Access to MR-Conditional Devices to Allow Patients and Providers to Make Informed and Collaborative Choices in the 21st Century ». Neuromodulation : Technology at the Neural Interface 18, n^o 4 (juin 2015) : 335–36. http://dx.doi.org/10.1111/ner.12305.

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Philippsen, T., M. Orini, C. A. Martin, E. Volkova, J. O. M. Ormerod, S. M. A. Sohaib, N. Elamin et al. « POSTERS (2)96CONTINUOUS VERSUS INTERMITTENT MONITORING FOR DETECTION OF SUBCLINICAL ATRIAL FIBRILLATION IN HIGH-RISK PATIENTS97HIGH DAY-TO-DAY INTRA-INDIVIDUAL REPRODUCIBILITY OF THE HEART RATE RESPONSE TO EXERCISE IN THE UK BIOBANK DATA98USE OF NOVEL GLOBAL ULTRASOUND IMAGING AND CONTINUEOUS DIPOLE DENSITY MAPPING TO GUIDE ABLATION IN MACRO-REENTRANT TACHYCARDIAS99ANTICOAGULATION AND THE RISK OF COMPLICATIONS IN PATIENTS UNDERGOING VT AND PVC ABLATION100NON-SUSTAINED VENTRICULAR TACHYCARDIA FREQUENTLY PRECEDES CARDIAC ARREST IN PATIENTS WITH BRUGADA SYNDROME101USING HIGH PRECISION HAEMODYNAMIC MEASUREMENTS TO ASSESS DIFFERENCES IN AV OPTIMUM BETWEEN DIFFERENT LEFT VENTRICULAR LEAD POSITIONS IN BIVENTRICULAR PACING102CAN WE PREDICT MEDIUM TERM MORTALITY FROM TRANSVENOUS LEAD EXTRACTION PRE-OPERATIVELY?103PREVENTION OF UNECESSARY ADMISSIONS IN ATRIAL FIBRILLATION104EPICARDIAL CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA ON UNINTERRUPTED WARFARIN : A SAFE APPROACH?105HOW WELL DOES THE NATIONAL INSTITUTE OF CLINICAL EXCELLENCE (NICE) GUIDENCE ON TRANSIENT LOSS OF CONSCIOUSNESS (T-LoC) WORK IN A REAL WORLD ? AN AUDIT OF THE SECOND STAGE SPECIALIST CARDIOVASCULAT ASSESSMENT AND DIAGNOSIS106DETECTION OF ATRIAL FIBRILLATION IN COMMUNITY LOCATIONS USING NOVEL TECHNOLOGY'S AS A METHOD OF STROKE PREVENTION IN THE OVER 65'S ASYMPTOMATIC POPULATION - SHOULD IT BECOME STANDARD PRACTISE?107HIGH-DOSE ISOPRENALINE INFUSION AS A METHOD OF INDUCTION OF ATRIAL FIBRILLATION : A MULTI-CENTRE, PLACEBO CONTROLLED CLINICAL TRIAL IN PATIENTS WITH VARYING ARRHYTHMIC RISK108PACEMAKER COMPLICATIONS IN A DISTRICT GENERAL HOSPITAL109CARDIAC RESYNCHRONISATION THERAPY : A TRADE-OFF BETWEEN LEFT VENTRICULAR VOLTAGE OUTPUT AND EJECTION FRACTION?110RAPID DETERIORATION IN LEFT VENTRICULAR FUNCTION AND ACUTE HEART FAILURE AFTER DUAL CHAMBER PACEMAKER INSERTION WITH RESOLUTION FOLLOWING BIVENTRICULAR PACING111LOCALLY PERSONALISED ATRIAL ELECTROPHYSIOLOGY MODELS FROM PENTARAY CATHETER MEASUREMENTS112EVALUATION OF SUBCUTANEOUS ICD VERSUS TRANSVENOUS ICD- A PROPENSITY MATCHED COST-EFFICACY ANALYSIS OF COMPLICATIONS & ; OUTCOMES113LOCALISING DRIVERS USING ORGANISATIONAL INDEX IN CONTACT MAPPING OF HUMAN PERSISTENT ATRIAL FIBRILLATION114RISK FACTORS FOR SUDDEN CARDIAC DEATH IN PAEDIATRIC HYPERTROPHIC CARDIOMYOPATHY : A SYSTEMATIC REVIEW AND META-ANALYSIS115EFFECT OF CATHETER STABILITY AND CONTACT FORCE ON VISITAG DENSITY DURING PULMONARY VEIN ISOLATION116HEPATIC CAPSULE ENHANCEMENT IS COMMONLY SEEN DURING MR-GUIDED ABLATION OF ATRIAL FLUTTER : A MECHANISTIC INSIGHT INTO PROCEDURAL PAIN117DOES HIGHER CONTACT FORCE IMPAIR LESION FORMATION AT THE CAVOTRICUSPID ISTHMUS ? INSIGHTS FROM MR-GUIDED ABLATION OF ATRIAL FLUTTER118CLINICAL CHARACTERISATION OF A MALIGNANT SCN5A MUTATION IN CHILDHOOD119RADIOFREQUENCY ASSOCIATED VENTRICULAR FIBRILLATION120CONTRACTILE RESERVE EXPRESSED AS SYSTOLIC VELOCITY DOES NOT PREDICT RESPONSE TO CRT121DAY-CASE DEVICES - A RETROSPECTIVE STUDY USING PATIENT CODING DATA122PATIENTS UNDERGOING SVT ABLATION HAVE A HIGH INCIDENCE OF SECONDARY ARRHYTHMIA ON FOLLOW UP : IMPLICATIONS FOR PRE-PROCEDURE COUNSELLING123PROGNOSTIC ROLE OF HAEMOGLOBINN AND RED BLOOD CELL DITRIBUTION WIDTH IN PATIENTS WITH HEART FAILURE UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY124REMOTE MONITORING AND FOLLOW UP DEVICES125A 20-YEAR, SINGLE-CENTRE EXPERIENCE OF IMPLANTABLE CARDIOVERTER DEFIBRILLATORS (ICD) IN CHILDREN : TIME TO CONSIDER THE SUBCUTANEOUS ICD?126EXPERIENCE OF MAGNETIC REASONANCE IMAGING (MEI) IN PATIENTS WITH MRI CONDITIONAL DEVICES127THE SINUS BRADYCARDIA SEEN IN ATHLETES IS NOT CAUSED BY ENHANCED VAGAL TONE BUT INSTEAD REFLECTS INTRINSIC CHANGES IN THE SINUS NODE REVEALED BY I (F) BLOCKADE128SUCCESSFUL DAY-CASE PACEMAKER IMPLANTATION - AN EIGHT YEAR SINGLE-CENTRE EXPERIENCE129LEFT VENTRICULAR INDEX MASS ASSOCIATED WITH ESC HYPERTROPHIC CARDIOMYOPATHY RISK SCORE IN PATIENTS WITH ICDs : A TERTIARY CENTRE HCM REGISTRY130A DGH EXPERIENCE OF DAY-CASE CARDIAC PACEMAKER IMPLANTATION131IS PRE-PROCEDURAL FASTING A NECESSITY FOR SAFE PACEMAKER IMPLANTATION ? » Europace 18, suppl 2 (octobre 2016) : ii36—ii47. http://dx.doi.org/10.1093/europace/euw274.

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Lapinskas, Tomas, Chiodi Elisabetta, Chrysanthos Grigoratos, Ricardo Ladeiras-Lopes, GJ Fent, E. Abdul Rahman, Jonathan Rodrigues et al. « VIEWING ONLY POSTERS1323Evaluation of right ventricular transverse strain and strain rate in patients with acute ST-segment elevation myocardial infarction : a cardiac magnetic resonance feature tracking study1333Cardiac resynchronization in ischemic heart failure patients : a comparison between therapy guided by cardiac magnetic resonance imaging and 2D-speckle tracking echocardiography1338Cardiac magnetic resonance versus bisphosphonate scintigraphy for diagnosis of cardiac amyloidosis1341Strain relaxation index, a novel tagged MRI-derived diastolic function parameter, is impaired in metabolic syndrome1349Global Longitudinal Strain Predicts Chronic Myocardial Infarction in Patients with Normal Ejection Fraction1352Optimal Dose Of Dobutamine During Low-Dose Dobutamine Stress Echocardiography In Correctly Identify Viable Segments On Cardiovascular Magnetic Resonance1368Absolute wall thickening and left ventricular ejection fraction–a unifying theory of myocardial contraction and heart failure?1376Transient St Elevation in Acs Like Myocarditis1379Patients after Fontan with a “total cavopulmonary connection” Fontan modification develop more collateral flow compared to “old-fashioned” Fontan modifications1387A MRI–derived 3D patient specific model for fibrosis quantification in atrial fibrillation1391Scar burden and survival in patients with ischemic cardiomyopathy and poor LV ejection fraction1392Relation of inflammatory markers with myocardial and microvascular injury in patients with reperfused ST- elevation myocardial infarction1406Equivalence of segmented conventional and fast single-shot late gadolinium enhancement (LGE) techniques for1410Cardiac Mri Appearances of Tuberculosis - A Review of Varied Presentations in India1415Atheroma burden, cardiac remodelling and epicardial fat : A comparison between healthy South Asian and European adults using Whole Body Cardiovascular MR1418Symptomatic Ventricular Arrhythmias : Diagnostic Yield of Cardiac Magnetic Resonance1421CMR assessment of aortic stiffness in asymptomatic low risk patients with type 2 diabetes mellitus1436Shock index as a predictor of myocardial damage and clinical outcome in ST-elevation myocardial infarction1451Combined biomarker testing for the prediction of microvascular obstruction after primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction1452A novel oscillometric technique compared with cardiac magnetic resonance for the assessment of aortic pulse wave velocity in ST-segment elevation myocardial infarction1456Aorto-pulmonary collaterals evaluated by CMR is associated to reduced “effective” cardiac index late after Fontan palliation1458Evaluation of pulmonary transit time and Pulmonary Blood Volume with first-pass perfusion CMR imaging in adult with repaired Congenital Heart disease1459Prognostic value of the cardiac magnetic resonance as a predictor of improvement in ventricular function after TakoTsubo syndrome1462Diagnostic performance of ECG detection of left atrial enlargement in patients with arterial hypertension relative to the cardiac magnetic resonance gold-standard : impact of obesity1463Utility of cardiac magnetic resonance imaging for diagnosis of cardiac sarcoidosis and prediction of therapeutic effects in patients with complete heart block and implanted magnetic resonance-conditional pacemaker : A multicenter study1467Cardiac magnetic resonance late gadolinium enhancement in patients with genetic dilated cardiomyopathy14712.Left ventricular hypertrophy in hypertensive patients–comparison of Cardiac Magnetic Resonance and Echocardiographic analysis of morphological and functional LV-parameters1472Is Angiographic Perfusion Score assessed in patients with acute myocardial infarction correlated with Cardiac Magnetic Resonance infarct size and N-terminal pro-brain natriuretic peptide in 6-month follow-up1476Cardiac Magnetic Resonance Patterns of Left Ventricular Diastolic Function In Hypertrophic Cardiomyopathy1477Impact of platelet volume on thrombus burden and tissue reperfusion in patients with STEMI treated with primary angioplasty : MRI study1479Right ventricle systolic function assessment and its prognostic implications in cardiac amyloidosis1484Cardiac MRI - an important tool in the evaluation of multsystemic inflamatory diseases. An Erdheim-Chester Disease case report1485Predictive value of cardiac magnetic resonance for future adverse cardiac events in patients with ST-segment elevation myocardial infarction1486Time-to-treatment but not thrombectomy influence infarct size and microvascular obstruction in patients with acute ST-segment elevation myocardial infarction treated with primary coronary intervention1489Primary PCI versus Early Routine Post Fibrinolysis PCI for ST Elevation Myocardial Infarction1490Evaluation of ventricular function in Fontan patients undergoing feature tracking magnetic resonance strain1491Impacts of atrialized right ventricle and left ventricular displacement in Ebstein's anomaly on left ventricular function assessed by cardiovascular MRI1494Final diagnosis for patients presenting with chest pain, electrocardiographic changes or troponin rise and normal coronary arteries : insights from Cardiovascular MRI in our population1495Early Predictive Factors of LV Remodeling after STEMI ; Assessment by Coronary Angiogram and Cadiovascular Magnetic Resonance1497The Pathobiologic Mechanisms and the Prognostic Meaning of t wave Inversion in Acute Myocarditis. a Study Performed by Cardiac Magnetic Resonance1501The Influence of Left Atrial Function on Exercise Tolerance in Patients with Heart Failure and Preserved Ejection Fraction : A Cardiac Magnetic Resonance Feature Tracking Study1504Microvascular Obstruction in Patients with Anterior ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention : Predictors and Impact on the Left Ventricular Function1508Histological Validation of ECV Quantification by Cardiac Magnetic Resonance T1 Mapping in Cardiac Amyloidosis1513Comparative Evaluation of Flow Quantification Across the Atrioventricular Valve in Patients with Functional Univentricular Heart After Fontan's Surgery and Healthy Controls : Measurement by 4D Flow Magnetic Resonance Imaging and Streamline Visualization1515Does arterial switch for d-transposition of the great arteries alter myocardial deformation of the ventricles?1527Accuracy of T1 Mapping by multi-professional CMR operators to predict myocardial infarct1531Detecting hypertensive heart disease : the additive value of cardiovascular magnetic resonance imaging1534Diagnostic Performance of Cardiac Magnetic Resonance Strain Parameters in Assesment of Myocardial Ischemia1535Relationships between left ventricular filling pressures and longitudinal dysfunction with myocardial fibrosis in uncomplicated hypertensive patients1539Predictive Clinical Factors of Tissue Damage Severity in Reperfused Acute Myocardial Infarction as Visualized by Cardiac Magnetic Resonance1541Which CMR derived parameter predicts better the need of invasive treatment in aortic coarctation?1543Contrast-enhanced magnetic resonance tomography in patients with supraventricular tachyarrhythmias1546Prognostic Value of CMR Imaging Biomarkers on Outcome in Peripheral Arterial Disease : a 6-year Follow-up Pilot Study1549Dobutamine-Stress-CMR in Young Adults after Arterial Switch Operation as Neonates1553Impact of posteromedial papillary muscle infarction on mitral regurgitation after ST-segment elevation myocardial infarction1556Role of cardiac magnetic resonance imaging in assessment of left ventricular hypertrophy1569Using intrinsic Cardiac Shear Waves to measure Myocardial Stiffness : Preliminary results from Patients with Heart failure with preserved Ejection Fraction1571Relationship of cerebrovascular reactivity and MRI pattern of carotid atherosclerotic plaque1577Feasibility study of an MR conditional pedal ergometer for cardiac stress MRI–preliminary results in healthy volunteers and patients with suspected coronary artery disease1581Pulmonary valve replacement for severe pulmonary stenosis has a positive effect on left ventricular remodeling1582The RV after cardiac surgery, more resilient than thought : multiparametric quantification shows altered rather than reduced function1584Usefulness of cardiovascular magnetic resonance to differentate coronary artery disease from non ischemic cardiomyoptathy in patients with heart failure1593What does CMR add to the ESC Risk Prediction Model to Assess the Occurrence of Sudden Cardiac Death in Patients with HCM?1597Detecting Progression of Diffuse Interstitial Fibrosis in Alstrom Syndrome1612Diffuse fibrosis in the ventricles of patients with transposition of great arteries late after atrial switch1631Utility of Cardiac Magnetic Resonance in the diagnosis and stratification of arrhythmic risk in patients with confirmed or suspected ventricular arrhythmias1635Size matters : pulmonary veins geometry by cardiac magnetic resonance imaging in atrial fibrillation patients1642How do the differences in Left Ventricular wall measurements from Echocardiography and CMR in patients with Hypertrophic Cardiomyopathy affect current Sudden Cardiac Death Risk Scores?1651Noninvasive assessment of intracardiac viscous energy loss in Fontan patients from 4D Flow CMR1653Behcet and Myocardial Infarction : A Rare Combination1328Impact of New Cerebral Ischemic Lesions On the Occurrence of Delirium after Transcatheter Aortic Valve Implantation1329Heart T2* assessment to measure iron overload using different software tools in patients with Thalassemia Major1332Hypertrabeculated Left Ventricle at Cardiac Magnetic Resonance Imaging : β-Thalassemia Major vs. Left Ventricular Non -Compaction Disease1335Aortic Regurgitation following Transcatheter Aortic Valve Implantation (TAVI) : a CMR Study of two prosthesis designs1336Incremental value of semi-quantitative evaluation of myocardium perfusion with 3T stress cardiac MRI1343Left ventricular morphological quantification with single shot and free-breathing SSFP cine imaging compared with standard breath-hold SSFP cine imaging1344Changes of cardiac iron and function during pregnancy in transfusion-dependent thalassemia patients1346Significant improvement of survival by T2* MRI in thalassemia major1350The impact of trans-catheter aortic valve implantation induced left-bundle branch block on cardiac reverse remodelling1351Value of magnetic resonance myocardial perfusion imaging in patients with indeterminate coronary computed tomography angiography results1353Gender differences in response to Transcatheter Aortic Valve implantation in patients with severe aortic stenosis assessed by feature tracking1354A qualitative assessment of first-pass perfusion bolus timings in the assessment of myocardial ischemia : A magnetic resonance study1355MRI prospective survey on cardiac iron and function and on hepatic iron in non transfusion-dependent thalassemia intermedia patients treated with desferrioxamine or non chelated1358Coronary Calcification Compromises Myocardial Perfusion Irrespective of Luminal Stenosis1359Non–contrast three–dimensional magnetic resonance imaging for pre–procedural assessment of aortic annulus dimensions in patients undergoing transcatheter aortic valve implantation1360“Systolic ventricularization” of the left atrium with bileaflet mitral valve prolapse : impact on quantification of mitral regurgitation1361CMR assessment of left ventricular remodeling 6 months after percutaneous edge-to-edge repair using Mitraclip1363Accuracy of Transthoracic Echocardiography (TTE) in comparison with Cardiac Magnetic Resonance (CMR)1374CMR for myocardial iron overload assessment : a new calibration curve from the MIOT project1381Can Speckle Tracking Imaging Reveal Myocardial Iron Overload in Thalassemia Major ? A Combined Echocardiography and Cardiac Magnetic Resonance Study1382Native myocardial T1 mapping in patients with pulmonary hypertension and age matched volunteers1384A Insidious Line Between Thalassemia Intermedia And Left Ventricular Non-Compaction Disease : The Role Of Cardiac Magnetic Resonance1388Pulmonary Artery : Ascending Aorta Diameter - An Important and Easily Measureable Prognostic Parameter1394Novel carotid artery ultrasound index–Extra-media thickness and a well-established cardiac magnetic resonance fat quantification method1403Validation of CMR-derived LVOT diameters against direct in-vivo measurements1409Early myocardial perfusion measured by CMR in acute myocardial infarction treated by primary PCI–a postconditioning study1420Assessment of paravalvular aortic regurgitation after transcatheter aortic valve implantation using cardiac magnetic resonance imaging : a comparative study with echocardiography and angiography1422Left atrial strain measured by feature tracking predicts left ventricular end diastolic filling pressure1426Validation of extracellular volume equation by serial cardiac magnetic resonance imaging measurements in patients with varying hematocrit1427Assessing diastolic function applying Cardiovascular Magnetic Resonance - comparison with the gold standard1475Role of Adenosine Stress Cardiac Mri in the Setting of Chronic Total Occlusion of Coronary Arteries1520Aortic Elasticity Indexes by Magnetic Resonance Predict Progression of Ascending Aorta Dilation1522Combined atrioventricular assessment of diastolic function by cardiac magnetic resonance1537Safety, image quality and clinical utility of cardiac magnetic resonance in patients with antiarrhythmic devices1538Usefulness of cardiac magnetic resonance to predict the need for surgical procedures in patients with mitral regurgitation1550Normal T1, T2, T2* and extracellular volume reference values in healthy volunteers at 3 Tesla cardiac magnetic resonance1551Comprehensive intra-ventricular myocardial deformation strain analysis in healthy volunteers : implications for regional myocardial disease processes1557Elastic properties changes of aorta in patients with dilatation of the ascending aorta evaluated by Magnetic Resonance1558The prevalence of active myocarditis assessed by cardiovascular magnetic resonance in patients with clinically suspected myocarditis1563Quantitative assessment of myocardial scar heterogeneity using texture analysis to risk stratify post–MI patients for ICD insertion1564Gender differences in exercise capacity and LV remodeling in response to pressure overload in aortic stenosis1572Myocardial wall stress as a novel CMR measure to assess cardiac function1573Feature tracking cardiac magnetic resonance to assess LV mechanics in pressure and volume overload1574Safety, feasibility and clinical impact of Cardiovascular Magnetic Resonance in patients with MR-conditional devices1576T1 Mapping at 1-Year Following Aortic Valve Replacement : Baseline Geometry Defines Magnitude of Fibrosis Regression1583Normal values of LV global myocardial mechanics using two and three-dimensional cardiovascular magnetic resonance1585Prediction of infarct transmurality in acute myocardial infarction based on cardiac magnetic resonance deformation analysis1595Measuring invasive blood pressure by catheters guided solely by Cardiovascular Magnetic Resonance by using a new guidewire without the need of a hybrid CMR-fluoroscopy suite1599Influence of active and passive cardiac implants on CMR image quality : results from a consecutive patient series1600Reproducibility of aortic 4D flow measurements in healthy volunteers1601An automatic approach to extract 4D flow hemodynamic markers : application in BAV-affected patients1602Global myocardial mechanics with 2 and 3-Dimensional cardiovascular magnetic resonance feature tracking in patients with myocarditis1603A CMR-based clinician-friendly assessment of in vivo left ventricle hemodynamics1604Reproducibility of left atrial strain using cardiovascular magnetic resonance myocardial feature tracking1605The severity of myocardial infarction in STEMI, determined by transmurality of infarct and infarct characteristics, impacts on myocardial T2 values1606MicroRNA as potential biomarkers of acute myocardial damage following STEMI1607Myocardial blush grade is associated with microvascular obstruction on CMR following STEMI16084D Flow CMR imaging : Comparison of conventional parallel imaging and variable density k-t acceleration1609In-vitro comparison of segmented-gradient-echo versus non-segmented echo planar imaging 4D Flow CMR : validation of flow volume and 3D vortex ring assessment1614Not just 2D but also 4D flow measurements in pulsatile phantom are accurate and reproducible1615Diffusion Tensor Imaging : Comparison of Hypertrophic Cardiomyopathy, Hypertension and Healthy Cohorts1624Impact of myocardial fibrosis measured by cardiac magnetic resonance imaging on reverse left ventricular remodelling after transcatheter aortic valve implantation1625Prosthetic valve regurgitation after transcatheter aortic valve implantation with new-generation devices compared to surgical aortic valve replacement–a cardiac magnetic resonance imaging flow measurement analysis1637Assessment of Aortic and Pulmonary Artery stiffness in Patients with COPD using Cardiac Magnetic Resonance1638Myocardial Mechanics implications using 2D Cardiovascular Magnetic Resonance in Aortic Regurgitation1639Delineation of myocardial infarction & ; viability by 12 lead ECG vs cardiac magnetic resonance1641Regional variation in native T1 values in normal healthy volunteers?1645Feasibility of myocardial strain assessment using tissue tracking at 3.0T CMR following ST-segment elevation myocardial infarction1648Diagnostic Impact of Cardiac Magnetic Resonance in patients with acute chest pain, troponin elevation and no significant angiographic coronary artery disease ». European Heart Journal – Cardiovascular Imaging 17, suppl 1 (mai 2016) : i37—i84. http://dx.doi.org/10.1093/ehjci/jew183.

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Bhuva, Anish, Geoff Charles-Edwards, Jonathan Ashmore, Alexandra Lipton, Matthew Benbow, David Grainger, Trudie Lobban et al. « Joint British Society consensus recommendations for magnetic resonance imaging for patients with cardiac implantable electronic devices ». Heart, 14 septembre 2022, heartjnl—2022–320810. http://dx.doi.org/10.1136/heartjnl-2022-320810.

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Magnetic Resonance Imaging (MRI) is increasingly a fundamental component of the diagnostic pathway across a range of conditions. Historically, the presence of a cardiac implantable electronic device (CIED) has been a contraindication for MRI, however, development of MR Conditional devices that can be scanned under strict protocols has facilitated the provision of MRI for patients. Additionally, there is growing safety data to support MR scanning in patients with CIEDs that do not have MR safety labelling or with MR Conditional CIEDs where certain conditions are not met, where the clinical justification is robust. This means that almost all patients with cardiac devices should now have the same access to MRI scanning in the National Health Service as the general population. Provision of MRI to patients with CIED, however, remains limited in the UK, with only half of units accepting scan requests even for patients with MR Conditional CIEDs. Service delivery requires specialist equipment and robust protocols to ensure patient safety and facilitate workflows, meanwhile demanding collaboration between healthcare professionals across many disciplines. This document provides consensus recommendations from across the relevant stakeholder professional bodies and patient groups to encourage provision of safe MRI for patients with CIEDs.

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Dowsing, B., L. Cash, E. Webb, J. C. Moon, C. H. Manisty et A. N. Bhuva. « MRI provision for patients with cardiac implantable electronic devices : understanding the real-world administrative requirements of service delivery ». European Heart Journal 42, Supplement_1 (1 octobre 2021). http://dx.doi.org/10.1093/eurheartj/ehab724.3042.

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Abstract Introduction Patients with cardiac implantable electronic devices (CIEDs) should have access to Magnetic Resonance Imaging (MRI) but are less likely to be referred and hospitals lack provision. A major barrier to service delivery is the administrative demand required to obtain accurate CIED details prior to scheduling. We aimed to understand the administrative requirements of a high-volume Cardiac Device-MRI service to inform the design of an electronic referrals platform that can facilitate workflow. Methods Single centre retrospective audit of a high-volume Cardiac Device-MRI service in a tertiary unit in the UK. Six months of referrals were reviewed for patient and CIED details and barriers met. Referrals were stratified by source, indication, MR-Conditional labelling and referrer. Results Administrative barriers were reviewed for 116 patients with CIEDs referred for MRI (48% cardiac, 52% non-cardiac) between September 2020 and March 2021 (Table 1). Referrers were 47% cardiologists and 53% other specialties. Referral to scan time was 15 days (interquartile range, 8–32). There were no scan-related complications. 34% of referrals contained complete CIED details and 30% stated the MR labelling of the CIED. None incorrectly labelled a CIED as MR-Conditional, but 8% incorrectly labelled as non-MR Conditional. 7 additional days were required to obtain complete CIED details where not provided (involving information requests from two device clinics in 27%), 10% had delays over 2 weeks (maximum 145 days). 35% required 3 or more repeat discussions with referrers after initial referral. Obtaining CIED information for external referrals required 17 days (11–42), compared to 14 (6–35) days for internal referrals (p=0.25). Patients with non-MR Conditional CIEDs required on average 14 days longer to obtain complete referral details than patients with MR-Conditional CIEDs. Even when referrers were aware of non-MR Conditional labelling and received information on risk, 41% required further discussion between patient and referrer regarding risks and benefits of MRI scanning. For cancer referrals, obtaining correct details took 1 day longer than other referrals (p=0.074) and required 2 extra emails to maintain provision within the national time-to-treatment target of 62 days. Missing data was similarly present in referrals from Cardiologists and non-Cardiologists (59% versus 61% respectively), but non-Cardiologists recorded more incorrect CIED details (8% vs 0%). Conclusions Referral for MRI in patients with CIEDs demands significant administrative input to obtain correct device information, leading to delays. These delays are greater for patients with non-MR conditional CIEDs, and data provided is often incorrect or incomplete. This may explain why some patients are not referred for MRI. An online referrals platform has been developed to streamline this process, initially deployed through a network of 60 centres registered in the UK. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This work is supported by British Heart Foundation Innovations funding (HFHF_016).

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Meier, C., M. Bietenbeck, S. Drakos, B. Chamling, V. Vehof, P. Stalling et A. Yilmaz. « Feasibility and image quality of myocardial perfusion imaging by CMR in patients with conditional and non-conditional cardiac devices ». European Heart Journal 43, Supplement_2 (1 octobre 2022). http://dx.doi.org/10.1093/eurheartj/ehac544.285.

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Abstract Purpose First, to determine image quality using different cardiovascular magnetic resonance (CMR) perfusion protocols in patients with all available active device types in a real-world setting, including non-conditional devices. Second, to demonstrate feasibility of high-quality perfusion imaging using spoiled gradient echo (sGE) protocols for non-invasive stress-testing. Methods From August 2020 to March 2022, N=222 patients with active cardiac implantable electronic devices (CIED) were scanned on a 1.5-T MR scanner (Philips Ingenia and Ambition). Our CMR scanning protocol was tailored to the clinical indication, and whenever myocardial perfusion imaging was possible, both a conventional steady-state-free-precession (SSFP)-based and a modified sGE-perfusion protocol were applied. Such a tailored perfusion protocol was performed in N=119 patients (70% men) with exclusively left-sided devices (pacemaker (PM), n=45; implantable cardioverter-defibrillator (ICD), n=46; subcutaneous ICD (S-ICD), n=15 and cardiac resynchronization therapy-pacemaker (CRT-P, n=5) or -defibrillator (CRT-D, n=8) with a percentage of 10% non-conditional devices. For assessment of image quality, a semi-quantitative 4-point grading scale was used based on a standard 16-segment model. Results A total of N=33 stress-tests with either regadenosone, adenosine or dobutamine and N=86 rest perfusion protocols were performed. Asynchronous pacing was required in 34% of the patients due to a heart rate of <40bpm. Device interrogation before and after CMR scanning showed no significant changes. Image quality was substantially better in sGE-based perfusion protocols compared to conventional SSFP-based perfusion in ICD, CRT-D and S-ICD patients (p<0.001). In patients with PM/ CRT-P image quality was neither significantly impaired in SSFP- nor in sGE-based protocols. Most device artefacts were located primarily in the anterior myocardial segments (1, 7, 13) in transvenous implanted devices and lateral in SICD-patients. A significant relationship between the extent of device artefacts and the parameters LVEDV (p=0.03), LVESV (p=0.005) and non-conditional devices (p=0.029) in SSFP-perfusion protocols were found in patients with PM/CRT-P. In contrast, there was no correlation between clinical and CMR-parameters in patients with ICD/ CRT-D. In S-ICD-patients, there was an inverse relationship between the extent of device artefact and age (p=0.006), BMI (p=0.001) in sGE-perfusion. Conclusion Myocardial perfusion imaging by CMR is safe and feasible with high image-quality in patients with all kinds of CIEDs – including MR-conditional as well as non-conditional devices. When performing CMR-based myocardial perfusion imaging in patients with left-sided ICD/CRT-D/S-ICD, a sGE-based perfusion-protocol should be preferred compared to conventional SSFP-based perfusion protocols in order to achieve artefact-free and well interpretable images. Funding Acknowledgement Type of funding sources: None.

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Patel, Bhavisha, Christopher Monkhouse, Charlotte Manisty et Nikos Papageorgiou. « Temporary device malfunction of an MR conditional cardiac resynchronization defibrillator when undergoing MRI without appropriate re-programming : a case report ». European Heart Journal - Case Reports 5, n^o 9 (1 septembre 2021). http://dx.doi.org/10.1093/ehjcr/ytab198.

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Abstract Background Magnetic resonance (MR) imaging (MRI) for patients with implantable cardiac devices is becoming more routine, with the development of MR conditional devices allowing more patients access to the imaging they need. However, for this to be performed safely, strict protocols must be followed necessitating close collaboration between cardiology and radiology departments. We present a case where mandatory device re-programming of a cardiac resynchronization therapy defibrillator device into MRI mode was not performed pre-scan leading to temporary device dysfunction with no clinical consequences. Case summary A 72-year-old man presented to a device clinic for a routine device interrogation. An atrial tachycardia response episode was recorded at the same time as the patient reported having undergone an MRI scan at a local centre. The electrogram demonstrated temporary right ventricular loss of capture with standard output programming, and a short episode of oversensing on the atrial and ventricular channel which was not sustained for long enough to meet tachycardia detection. Discussion We demonstrate two potential electrophysiological effects of MRI on pacemakers, where the device had not been appropriately re-programmed pre-procedure. This illustrates that whilst MRI in patients with implantable cardiac devices is safe, strict protocols must be followed requiring robust multidisciplinary communication.

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Pavon, Anna Giulia, Alessandra Pia Porretta, Dimitri Arangalage, Giulia Domenichini, Tobias Rutz, Sarah Hugelshofer, Etienne Pruvot, Pierre Monney, Patrizio Pascale et Juerg Schwitter. « Feasibility of adenosine stress cardiovascular magnetic resonance perfusion imaging in patients with MR-conditional transvenous permanent pacemakers and defibrillators ». Journal of Cardiovascular Magnetic Resonance 24, n^o 1 (13 janvier 2022). http://dx.doi.org/10.1186/s12968-021-00842-0.

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Abstract Background The use of stress perfusion-cardiovascular magnetic resonance (CMR) imaging remains limited in patients with implantable devices. The primary goal of the study was to assess the safety, image quality, and the diagnostic value of stress perfusion-CMR in patients with MR-conditional transvenous permanent pacemakers (PPM) or implantable cardioverter-defibrillators (ICD). Methods Consecutive patients with a transvenous PPM or ICD referred for adenosine stress-CMR were enrolled in this single-center longitudinal study. The CMR protocol was performed using a 1.5 T system according to current guidelines while all devices were put in MR-mode. Quality of cine, late-gadolinium-enhancement (LGE), and stress perfusion sequences were assessed. An ischemia burden of ≥ 1.5 segments was considered significant. We assessed the safety, image quality and the occurrence of interference of the magnetic field with the implantable device. In case of ischemia, we also assessed the correlation with the presence of significant coronary lesions on coronary angiography. Results Among 3743 perfusion-CMR examinations, 66 patients had implantable devices (1.7%). Image quality proved diagnostic in 98% of cases. No device damage or malfunction was reported immediately and at 1 year. Fifty patients were continuously paced during CMR. Heart rate and systolic blood pressure remained unchanged during adenosine stress, while diastolic blood pressure decreased (p = 0.007). Six patients (9%) had an ischemia-positive stress CMR and significant coronary stenoses were confirmed by coronary angiography in all cases. Conclusion Stress perfusion-CMR is safe, allows reliable ischemia detection, and provides good diagnostic value.

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« BIOBOARD ». Asia-Pacific Biotech News 20, n^o 07 (juillet 2016) : 53–60. http://dx.doi.org/10.1142/s0219030316000525.

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SINGAPORE – New Material Kills E. Coli Bacteria in 30 Seconds. SINGAPORE – Real-Time Imaging of Embryo Development Could Pave the Way for More Effective Human Reproduction Therapies. UNITED STATES – Innovative Device Allows 3D Imaging of the Breast with Less Radiation. UNITED STATES – BIOTRONIK Launches Smallest MR Conditional Pacing Lead Available in the United States. UNITED STATES – Computer App Whets Children's Appetites for Eco-Friendly Meals. AUSTRALIA & CHINA – Uscom Agreement with CIIC Shanghai. JAPAN – Chugai Announces License Agreement for Recycling Antibody SA237. KOREA – ORIG3N(TM) and Kangstem Biotech Announce Collaboration to Study Neural Stem Cells.

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Lim, Yeong-Min, Jae-Sun Uhm, Min Kim, In-Soo Kim, Moo-Nyun Jin, Hee Tae Yu, Tae-Hoon Kim et al. « Subclinical cardiac perforation by cardiac implantable electronic device leads detected by cardiac computed tomography ». BMC Cardiovascular Disorders 21, n^o 1 (19 juillet 2021). http://dx.doi.org/10.1186/s12872-021-02159-3.

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Abstract Background The relationship between the characteristics of cardiac implantable electronic device (CIED) leads and subclinical cardiac perforations remains unclear. This study aimed to evaluate the incidence of subclinical cardiac perforation among various CIED leads using cardiac computed tomography (CT). Methods A total of 271 consecutive patients with 463 CIED leads, who underwent cardiac CT after CIED implantation, were included in this retrospective observational study. Cardiac CT images were reviewed by one radiologist and two cardiologists. Subclinical perforation was defined as traversal of the lead tip past the outer myocardial layer without symptoms and signs related to cardiac perforation. We compared the subclinical cardiac perforation rates of the available lead types. Results A total of 219, 49, and 3 patients had pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy, respectively. The total subclinical cardiac perforation rate was 5.6%. Subclinical cardiac perforation by screw-in ventricular leads was significantly more frequent than that caused by tined ventricular leads (13.3% vs 3.3%, respectively, p = 0.002). There were no significant differences in the incidence of cardiac perforation between atrial and ventricular leads, screw-in and tined atrial leads, pacing and defibrillator ventricular leads, nor between magnetic resonance (MR)-conditional and MR-unsafe screw-in ventricular leads. Screw-in ventricular leads were significantly associated with subclinical cardiac perforation [odds ratio, 4.554; 95% confidence interval, 1.587–13.065, p = 0.005]. There was no case subclinical cardiac perforation by septal ventricular leads. Conclusions Subclinical cardiac perforation by screw-in ventricular leads is not rare. Septal pacing may be helpful in avoiding cardiac perforation.

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Koshy, A., J. Gierula, M. Paton, P. Swoboda, A. G. Toms, C. Saunderson, D. Shelley et al. « Partial normalisation of cardiac mechanics with active CRT in patients with chronic failure : a novel application of 3.0T CMR ». European Heart Journal 41, Supplement_2 (1 novembre 2020). http://dx.doi.org/10.1093/ehjci/ehaa946.1091.

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Abstract Introduction Cardiac resynchronisation therapy (CRT) is a routine treatment for chronic heart failure (CHF) with reduced ejection fraction and conduction delay to improve prognosis. Cardiac mechanics in patients with CHF are believed to be altered from controls based on invasive and echocardiographic based data. Technological advancements in cardiac magnetic resonance (CMR) and devices enable investigation of the cardiac response to CRT over a range of heart rates. Methods Patients with a CRT-D device were enrolled from heart failure clinics at Leeds General Infirmary, UK. After a MRI safety assessment, a baseline device check was conducted by a cardiac physiologist. Left ventricular (LV) volumes and systolic BP were measured at baseline and heart rates of 75, 90, 100, 115, 125, and 140 (randomised order) with CRT active and intrinsic conduction. All scans were conducted using a 3.0 T Siemens Prisma MRI scanner. Analysis of the scans used commercially available software. LV contractility was derived as a ratio of the LV end systolic volume and systolic BP. A post scan device interrogation was conducted to assess for scanning safety. Control participants with a 3.0T MR-conditional dual chamber pacemakers completed a similar protocol. Results Scanning was conducted in 17 CRT patients and 13 controls with a pre and post device and lead interrogation. No patient experienced symptoms related to scanning or device failure. The mean LV ejection fraction at baseline in the CRT cohort was 33.7±12.9%. Left ventricular ejection fraction fell across both cohorts as paced heart rate increased with reduced deterioration in control patients and those with CRT active. Peak LV cardiac output was significantly higher during active CRT (p<0.05). LV contractility was relatively static with CRT disabled (r2=0.13, p=0.38) and improved with CRT active (r2=0.91, p=0.01) and in controls (r2=0.74, p=0.01). Peak LV strain occurred at 100bpm during active CRT and in control patients whereas CRT disabled resulted in earlier deterioration. Conclusion We have demonstrated improvements in cardiac output and contractility consequent to active CRT using 3.0T CMR and subsequently validated via strain analysis. CRT appears to partially normalise cardiac mechanics across the range of heart rates studied. Further work is required to explore this phenomenon on a cellular or metabolic level. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): AK is supported by an unconditional grant provided by Medtronic

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Mariani, Andrea, Alessandra Scatteia, Francesca Frecentese, Carmine Emanuele Pascale, Giuseppe Russo, Giovanni Esposito et Santo Dellegrottaglie. « 1020 UTILITY OF CARDIAC MAGNETIC RESONANCE FOR INITIAL AND FOLLOW-UP EVALUATION OF A PATIENT WITH COMPLICATED ACUTE MYOCARDITIS ». European Heart Journal Supplements 24, Supplement_K (14 décembre 2022). http://dx.doi.org/10.1093/eurheartjsupp/suac121.635.

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Abstract A 20-year-old woman with a history of pneumonia, polycystic ovarian syndrome and ovarian teratoma asportation presented with chest pain and worsening dyspnoea. No prodromal or concomitant infective symptoms were reported. On admission, vital parameters were within normal limits, ECG was unremarkable and laboratory tests revealed high white blood cells count and increased hs-cTnI. Transthoracic echocardiography showed diffuse left ventricular (LV) dysfunction, with akinesia of basal segments and a severely reduced ejection fraction (LVEF = 27%). A full heart failure drug treatment was gradually introduced and, after two weeks, a cardiac magnetic resonance (CMR) was performed. CMR showed significant but incomplete recovery of LV systolic function (LVEF = 40%), extensive areas of myocardial oedema with diffuse LV involvement on STIR (short tau inversion recovery) images (Fig. A) and, almost with the same LV distribution, considerable late gadolinium enhancement (LGE) with subepicardial/intramyocardial distribution on post-Gadolinium images (Fig. B-C); all these findings strongly suggested an acute myocarditis with diffuse LV myocardial damage. Definitive diagnosis was made through endo-myocardial biopsy, that revealed significant infiltration of lymphocytes, without additional specific elements. Patient was sent home with an optimized drug therapy for heart failure with reduced ejection fraction and a close clinical follow-up was prescribed. Roughly a month after discharge the patient presented with sustained ventricular tachycardia that required prompt admission and DC shock. Hence, an MR-conditional transvenous ICD was implanted without complications. After 7 months from the acute event, patient underwent a follow-up CMR that, despite artifacts produced by ICD generator and intracavitary leads, still displayed reduced LV systolic function (LVEF = 41%) and extensive LGE with a non-ischemic “ring-like” LV pattern (Fig. D-E). Finally, patient has been put on the waiting list for heart transplantation and, in order to exclude left-dominant arrhythmogenic cardiomyopathy (LDAC), genetic tests have been ordered, but are still pending. The present case emphasizes the importance of CMR for the initial assessment of patients with acute myocarditis: beyond the crucial role in evaluating extension and severity of the inflammatory process at the myocardial level, it can identify specific features (i.e. ring-like or antero-septal patterns of LGE involvement), more frequently reported in high-risk subgroups, such as LDAC, with suggestion for further investigations (including genetic tests for desmosomal mutations). During follow-up, CMR retains a central role to evaluate possible changes in ventricular function and in extension of myocardial tissue involvement, useful to guide the cardiologist to choose for a more tailored management and define a more precise timing for further follow-up. Progressive expansion of CMR indications is helping to understand the pathophysiology of many cardiac conditions (including myocarditis and myocarditis-like entities) and many of the previous limitations to its wider clinical use have progressively been settled. From the present case, it can be appreciated how, even in presence of an implanted cardiac device, precious diagnostic information can still be obtained using CMR. However, to ensure safety and feasibility, MR-conditional devices need to be appropriately checked and reprogrammed before and immediately after the exam, while adapted CMR imaging protocols and adequate patient monitoring need to be applied during the scan.

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« Corrigendum to : Temporary device malfunction of an MR conditional cardiac resynchronization defibrillator when undergoing MRI without appropriate re-programming : a case report [Eur Heart J Case Reports (2022) ; https://doi.org/10.1093/ehjcr/ytab198] ». European Heart Journal - Case Reports 6, n^o 4 (1 avril 2022). http://dx.doi.org/10.1093/ehjcr/ytac132.

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Liang, Haipeng, et Zion Tsz Ho Tse. « MR conditional prostate intervention systems and actuations review ». Proceedings of the Institution of Mechanical Engineers, Part H : Journal of Engineering in Medicine, 1 décembre 2022, 095441192211361. http://dx.doi.org/10.1177/09544119221136169.

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Magnetic resonance imaging (MRI) has the ability to provide high-resolution images of soft tissues without the use of radiation. So much research has been focused on the development of actuators and robotic devices that can be used in the MRI environment so “real-time” images can be obtained during surgeries. With real-time guidance from MRI, robots can perform surgical procedures with high accuracy and through less invasive routes. This technique can also significantly reduce the operation time and simplify pre-surgical procedures. Therefore, research on robot-assisted MRI-guided prostate intervention has attracted a great deal of interest, and several successful clinical trials have been published in recent years, pointing to the great potential of this technology. However, the development of MRI-guided robots is still in the primary stage, and collaboration between researchers and commercial suppliers is still needed to improve such robot systems. This review presents an overview of MRI-guided prostate intervention devices and actuators. Additionally, the expected technical challenges and future advances in this field are discussed.

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Samar, Huma, June Yamrozik, Moneal Shah, Ronald B. Williams, Mark Doyle, Christopher A. Bonnet et Robert W. Biederman. « Abstract 14195 : Diagnostic Value of MRI in Patients With Implanted Cardiac Devices : Does the Benefit Justify the Risk ? » Circulation 132, suppl_3 (10 novembre 2015). http://dx.doi.org/10.1161/circ.132.suppl_3.14195.

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Background: MRI is infrequently performed on patients with conventional pacemakers/ICD’s. Multiple recent studies and registries (MagnaSafe) have documented the safety of MRI in these patients, yet the diagnostic value of this approach has not been established remaining a critical issue to advance this field in an era of progressive MRI useage. Objective: 1) to examine a protocol to assess the diagnostic utility of thoracic and non-thoracic MRI in patients with implantable devices and 2) to determine if there is substantial benefit to the pt with regard to diagnosis and/or management. Methods: Over 8 years, 134 pts with PM/AICD’s underwent MRI (GE, 1.5T Milwaukee, WI) at a single institution. Specific criteria were followed for all pts to objectively define whether final diagnosis by MRI imaging enhanced patient care. A checklist of three questions was answered following scan interpretation by both the technologist and performing MRI physician(s):1) Did the primary diagnosis change? 2) Did the MRI provide additional information to the existing diagnosis? 3) Did patient management change? If ’Yes’ was answered to any of the above questions, it was considered that the MRI scan was of value to patient diagnosis and/or therapy. Results: All 134 pts underwent MRI/CMR without complications: avg scan time 24±9min including 42 pts with ICD’s, 5 pts with a retained lead and 87 non-MR conditional pacemakers. In 83% (n=112) MR added value to patient diagnosis and management. In 64% (n=86) MRI added additional valuable information to the primary diagnosis and in 19% (n=26) MRI was life-saving, changing the principal diagnosis and subsequent management of the pt. There were no deaths, arrhythmias or power-on-resets encountered and no adverse effects were noted in any pt. No post-procedure revisions or reimplantations of generator/lead were required. Conclusions: MR imaging in patients with implanted cardiac devices adds substantial value to patient diagnosis and management justifying the risk of the procedure. In this real-world patient population, we have shown that MR imaging retains its very high diagnostic yield. Risk-benefit ratios clearly justify the performance of MRI even in this higher risk population, that is, until such time as MR-conditional devices are universal.

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Sabzevari, Kian, James Oldman, Anna S. Herrey, James C. Moon, Anna C. Kydd et Charlotte Manisty. « Provision of magnetic resonance imaging for patients with ‘MR-conditional’ cardiac implantable electronic devices : an unmet clinical need ». Europace, 2 juin 2016, euw063. http://dx.doi.org/10.1093/europace/euw063.

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Ahmed, Nauman, Amardeep Ghosh Dastidar, Elisa McAlindon, Chris B. Lawton, Daniel Augustine, Glyn Thomas, Edward Duncan, Tim Cripps, Ihab Diab et Chiara Bucciarelli-Ducci. « Cardiovascular magnetic resonance imaging in patients with MR-conditional devices : a UK tertiary centre experience on image quality and change in patients management ». Journal of Cardiovascular Magnetic Resonance 17, S1 (3 février 2015). http://dx.doi.org/10.1186/1532-429x-17-s1-p238.

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