Safety and Quality of 1.5-T MRI in Patients With Conventional and MRI-Conditional Cardiac Implantable Electronic Devices After Implementation of a Standardized Protocol

Heart failure (HF) hospitalisations due to decompensation are associated with shorter life expectancy and lower quality of life. These hospitalisations pose a significant burden on the patients, doctors and healthcare resources. Early detection of an upcoming episode of decompensation may facilitate timely optimisation of the ambulatory medical treatment and thereby prevent heart-failure-related hospitalisations. The HeartLogicTM algorithm combines data from five sensors of cardiac implantable electronic devices into a cumulative index value. It has been developed for early detection of fluid retention in heart failure patients. This review aims to provide an overview of the current literature and experience with the HeartLogicTM algorithm, illustrate how the index can be implemented in daily clinical practice and discuss ongoing studies and potential future developments of interest.

Download Full-text

Upper extremity dysfunctions in patients with cardiac implantable electronic devices: a systematic review

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2020.0160 ◽

2021 ◽

Vol 28 (7) ◽

pp. 1-18

Author(s):

Praveen Jayaprabha Surendran ◽

Prasobh Jacob ◽

Dineshkumar Selvamani ◽

Theodoros Papasavvas ◽

Narasimman Swaminathan ◽

...

Keyword(s):

Systematic Review ◽

Range Of Motion ◽

Upper Extremity ◽

Electronic Device ◽

Electronic Devices ◽

Cochrane Central Register ◽

Cardiac Implantable Electronic Device ◽

Cardiac Implantable Electronic Devices ◽

Shoulder Range Of Motion

Background/Aims The prevalence of cardiac implantable electronic devices has risen considerably during recent years. This has revolutionised the treatment of cardiac arrhythmias, which in turn reduced the incidence of sudden cardiac death. There are several complications associated with cardiac implantable electronic device implantation. Upper extremity dysfunction is one of the complications associated with this procedure and it should be addressed, since it can affect activities of daily living. This systematic review analysed the prevailing evidence pertaining to the common upper extremity dysfunctions associated with receiving a cardiac implantable electronic device. Methods A comprehensive literature search was conducted using PubMed, Cochrane Central Register of Controlled Trials, EMBASE (through Cochrane) and Google Scholar for original research published in the English language. The Rayyan QCRI web application was used for study selection and the decision-making process. PRISMA guidelines were used to conduct and report this review. The methodological quality of the included studies was appraised using the Newcastle–Ottawa Scale and Joanna Briggs Institute critical appraisal tool for analytic cross-sectional studies and case reports. Results This systematic review included eight studies with a total of 696 participants. The most common upper extremity dysfunctions associated with receiving a cardiac implantable electronic device were pain and limitation of shoulder range of motion. Limitation of range of motion could be persisted even in the long term after having a cardiac implantable electronic device implanted. Conclusions Contributing factors of upper extremity dysfunctions included size of the device, pectoral site of implantation and upper extremity immobilisation practices. Upper extremity dysfunction is an overlooked complication, as it received a relatively low priority, although it may negatively impact quality of life.

Download Full-text

Performing MRI on patients with MRI-conditional and non-conditional cardiac implantable electronic devices: an update for radiologists

Clinical Radiology ◽

10.1016/j.crad.2019.07.006 ◽

2019 ◽

Vol 74 (12) ◽

pp. 912-917 ◽

Cited By ~ 3

Author(s):

A. Cunqueiro ◽

M.L. Lipton ◽

R.J. Dym ◽

V.R. Jain ◽

J. Sterman ◽

...

Keyword(s):

Electronic Devices ◽

Cardiac Implantable Electronic Devices ◽

Mri Conditional

Download Full-text

Canadian Heart Rhythm Society and Canadian Association of Radiologists Consensus Statement on Magnetic Resonance Imaging with Cardiac Implantable Electronic Devices

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2014.08.001 ◽

2014 ◽

Vol 65 (4) ◽

pp. 290-300 ◽

Cited By ~ 11

Author(s):

Atul Verma ◽

Andrew C.T. Ha ◽

Carole Dennie ◽

Vidal Essebag ◽

Derek V. Exner ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Electronic Devices ◽

Heart Rhythm ◽

Resonance Imaging ◽

Cardiac Implantable Electronic Devices ◽

Canadian Association ◽

Mri Environment ◽

Magnetic Resonance Imaging Mri ◽

Mri Conditional

Magnetic resonance imaging (MRI) has historically been considered contraindicated for individuals with cardiac implantable electronic devices (CIEDs) such as pacemakers and implantable defibrillators. Magnetic resonance scanners produce magnetic fields that can interact negatively with the metallic components of CIEDs. However, as CIED technology has advanced, newer MRI conditional devices have been developed that are now in clinical use and these systems have had demonstrated safety in the MRI environment. Despite the supportive data of such CIED systems, physicians remain reluctant to perform MRI scanning of conditional devices. This joint statement by the Canadian Heart Rhythm Society and the Canadian Association of Radiologists describes a collaborative process by which CIED specialists and clinics can work with radiology departments and specialists to safely perform MRI in patients with MRI conditional CIED systems. The steps required for patient and scanning preparation and the roles and responsibilities of the CIED and radiology departments are outlined. We also briefly outline the risks and a process by which patients with nonconditional CIEDs might also receive MRI in highly specialized centres. This document supports MRI in patients with MRI conditional CIEDs and offers recommendations on how this can be implemented safely and effectively.

Download Full-text

Recommendations from the Association for European Paediatric and Congenital Cardiology for training in diagnostic and interventional electrophysiology

Cardiology in the Young ◽

10.1017/s1047951120004096 ◽

2020 ◽

pp. 1-9

Author(s):

Thomas Kriebel ◽

Eric Rosenthal ◽

Roman Gebauer ◽

Juha-Matti Happonen ◽

Fabrizio Drago ◽

...

Keyword(s):

Congenital Heart ◽

Heart Defects ◽

Electronic Devices ◽

Paediatric Cardiology ◽

Non Invasive ◽

Cardiac Implantable Electronic Devices ◽

Interventional Electrophysiology ◽

European Paediatric ◽

Inherited Arrhythmias

Abstract The field of electrophysiology (EP) in paediatric cardiology patients and adults with congenital heart disease is complex and rapidly growing. The current recommendations for diagnostic and invasive electrophysiology of the working group for Cardiac Dysrhythmias and Electrophysiology of the Association for European Paediatric and Congenital Cardiology acknowledges the diveristy of European countries and centers. These training recommendations can be fulfilled in a manageable period of time, without compromising the quality of training required to become an expert in the field of paediatric and congenital EP and are for trainees undergoing or having completed accredited paediatric cardiologist fellowship. Three levels of expertise, the training for General paediatric cardiology EP, for non-invasive EP and invasive EP have been defined. This Association for European EP curriculum describes the theoretical and practicsal knowledge in clinical EP; catheter ablation, cardiac implantable electronic devices, inherited arrhythmias and arrhythmias in adults with congenital heart defects for the 3 levels of expertise.

Download Full-text

Re: Performing MRI on patients with MRI-conditional and non-conditional cardiac implantable electronic devices: an update for radiologists

Clinical Radiology ◽

10.1016/j.crad.2020.01.017 ◽

2020 ◽

Vol 75 (5) ◽

pp. 391-393

Author(s):

A.N. Bhuva ◽

A.J. Baksi ◽

G. Charles-Edwards ◽

G. Roditi ◽

C. Manisty

Keyword(s):

Electronic Devices ◽

Cardiac Implantable Electronic Devices ◽

Mri Conditional

Download Full-text

Is diversity harmful?—Mixed-brand cardiac implantable electronic devices undergoing magnetic resonance imaging

Wiener klinische Wochenschrift ◽

10.1007/s00508-021-01924-w ◽

2021 ◽

Author(s):

Christoph Alexander König ◽

Florian Tinhofer ◽

Thomas Puntus ◽

Achim Leo Burger ◽

Nikolaus Neubauer ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Electronic Devices ◽

Resonance Imaging ◽

Cardiac Implantable Electronic Devices ◽

Primary Endpoints ◽

Increased Risk ◽

Secondary Endpoints ◽

Magnetic Resonance Imaging Mri ◽

Mri Conditional

Summary Background Many patients with cardiac implantable electronic devices (CIED) undergo magnetic resonance imaging (MRI); however, a relevant proportion have a CIED system that has not been classified as MRI-conditional because of generators and leads from different brands (mixed-brand group). The available data concerning the outcome of these mixed patients undergoing MRI is limited. Methods A retrospective single center study, including all patients with CIEDs undergoing MRI between January 2013 until May 2020, was performed. Primary endpoints were defined as death or any adverse event necessitating hospitalization or CIED revision. Secondary endpoints were the occurrence of any sign for beginning device or lead failure or patient discomfort during MRI. Results A total of 227 MRI examinations, including 10 thoracic MRIs, were carried out in 158 patients, with 1–9 MRIs per patient. Of the patients 38 underwent 54 procedures in the mixed-brand group and 89 patients underwent 134 MRIs in the MRI-conditional group. Of the patients 31 were excluded since the MRI conditionality could not be determined. No primary endpoints occurred within the mixed-brand group but in 2.2% of the MRI-conditional group (p = 1.000), with 2 patients developing new atrial fibrillation during MRI, of whom one additionally had a transient CIED dysfunction. No secondary endpoints were met in the mixed-brand group compared to 3.4% in the MRI-conditional group (p = 0.554). No complications occurred in the excluded patients. Conclusion The complication rate of CIED patients undergoing MRI was low. Patients with a mixed CIED system showed no signs of increased risk of adverse events compared to patients with MRI-conditional CIED systems.

Download Full-text