scholarly journals Remote Programming of Cardiac Implantable Electronic Devices: A Novel Approach to Program Cardiac Devices for Magnetic Resonance Imaging

2021 ◽  
Author(s):  
Sisir Siddamsetti ◽  
Alexander Shinn ◽  
Sandeep Gautam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Electronic Devices ◽  
Remote Access ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Devices ◽  
Access Code ◽  
Mri Scans

Background Magnetic Resonance imaging (MRI) in patients (pts) with MRI-conditional cardiovascular implantable electronic devices (CIED) remain a logistical issue for device programming during the scan. In current practice, a trained person needs to be present on-site to program CIED for MRI scan. This can cause delay in patient care, rescheduling of tests and increase healthcare costs. A novel remote programming (RP) strategy can be utilized to reprogram the CIED remotely. We sought to explore the feasibility and safety of RP of CIED’s in pts undergoing MRI scan. Methods We implemented the Medtronic CIED RP software at our institution after ensuring HIPAA compliance. The MRI technician started the session by contacting an off-site remote operator and placing a programmer wand from 2090 Medtronic programmer over CIED. The remote operator logged into a remote access software and provided a unique access code to the MRI technician. After entering the access code into the programmer, the remote operator was able to program the device as needed. We conducted a periodic audit of the first 209 pts who underwent RP of CIED’s for MRI. Outcomes analyzed were safety parameters during RP. Results Of the 209 MRI scans, 51 scans were performed urgently. There were no connectivity and programming problems or need for MRI rescheduling. In-person reprogramming was not required for any pt. All scans were completed safely in a timely manner, and there were no reports of CIED malfunction. Conclusions Remote programming of CIED’s for MRI scans is a safe and effective strategy.

P4126Safety of magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices: A systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Padmanabhan ◽  
M Farwati ◽  
A Izath ◽  
A Al-Masry ◽  
D Kella ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Adverse Events ◽  
Meta Analysis ◽  
Electronic Devices ◽  
Binary Outcomes ◽  
Resonance Imaging ◽  
Pacing Threshold ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients

Abstract Recent guideline statements approve the performance of magnetic resonance imaging (MRI) in patients with non-conditional cardiac implantable electronic devices (CIEDs) under certain closely monitored conditions. Data from current registries may have lower power to discern changes that may occur in the CIED after the MRI. Objective We aimed to systematically review the literature to identify the adverse events and significance of changes in device function associated with performing MRI in patients with CIEDs Methods A comprehensive literature search of the databases was performed between 1980- 2017. Two independent reviewers selected studies and extracted data. A random-effects model was used for meta-analysis. Results A total of 7,422 patients underwent 8,865 MRI studies. No death occurred post MRI. Clinical adverse events were extremely rare (mostly less than 1%) and are summarized in Table 1. No significant changes in the pooled mean effect size estimate was noted for the changes in the lead parameters (pacing threshold, sensing and impedance) Binary outcomes post magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices Outcome Sample size Number of patients Rate SE LL of CI UL of CI Death 7401 0 0 0 0 0 Atrial arrhythmia 7173 10 0.001 0.0004 0.0007 0.0024 Ventricular arrhythmia 7371 9 0.0012 0.0004 0.0006 0.0022 Oversensing 4981 17 0.0034 0.0008 0.0020 0.0053 Inhibition of pacing 7371 6 0.0008 0.0003 0.0003 0.0016 Lead Failure/Generator Failure 7475/7475 2/8 0.0002/0.0011 0.0001/0.0004 0.0001/0.0005 0.0009/0.002 Power on Reset 1388 105 0.0131 0.0014 0.0107 0.0161 Did not complete scan 6851 13 0.0019 0.0005 0.0011 0.0031 Chest pain 7080 11 0.0021 0.0004 0.0008 0.0027. Lead threshold rise (>0.5v/>50%-A/V) 5076/6246 12/16 0.0024/0.0026 0.0007/0.0006 0.0013/0.0015 0.0040/0.0041 Change in Battery voltage >0.04V 7132 42 0.0061 0.0009 0.0043 0.0079 Sensing decrease >50%-A/V 5087/5834 17/9 0.0033/0.0015 0.0008/0.0005 0.0020/0.0008 0.0052/0.0028 Impedance changes >50ohms/>50% 5810 22 0.0038 0.0008 0.0024 0.0057 Rise in cardiac enzymes 1703 26 0.0152 0.0030 0.0102 0.0219 A, atrial; V, ventricular; SE, standard Error; LL, lower limit; UL, upper limit; CI, Confidence intervals. Conclusions MRI in patients with non-conditional CIEDs can be performed with high degree of safety and low rate of clinical events when performed under standardized protocols Acknowledgement/Funding None

scholarly journals Guidelines for Performing Nuclear Magnetic Resonance Imaging Examinations in Patients with Cardiac Electronic Devices

2019 ◽  
Vol 32 (2) ◽  
pp. 122-126
Author(s):  
Antonio Vitor Moraes Junior ◽  
Bruno Pereira Valdigem ◽  
Cecilia Monteiro Boya Barcelos ◽  
Celso Salgado de Melo ◽  
Wilson Lopes Pereira ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Nuclear Magnetic Resonance ◽  
Magnetic Resonance ◽  
Electronic Devices ◽  
Nuclear Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Cardiac Implantable Electronic Devices ◽  
Magnetic Resonance Imaging Mri ◽  
Nuclear Magnetic

It is estimated that up to 75% of patients with cardiac implantable electronic devices (CIEDs) will have an indication for nuclear magnetic resonance imaging (MRI) throughout their lives. Th is population has been historically excluded from the list of patients considered eligible for this examination due to the characteristics of the devices.

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