Feasibility of adenosine stress cardiovascular magnetic resonance perfusion imaging in patients with MR-conditional transvenous permanent pacemakers and defibrillators.

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Version: author
License: CC BY 4.0
Serval ID
serval:BIB_1AC2979461B5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Feasibility of adenosine stress cardiovascular magnetic resonance perfusion imaging in patients with MR-conditional transvenous permanent pacemakers and defibrillators.
Journal
Journal of cardiovascular magnetic resonance
Author(s)
Pavon A.G., Porretta A.P., Arangalage D., Domenichini G., Rutz T., Hugelshofer S., Pruvot E., Monney P., Pascale P., Schwitter J.
ISSN
1532-429X (Electronic)
ISSN-L
1097-6647
Publication state
Published
Issued date
13/01/2022
Peer-reviewed
Oui
Volume
24
Number
1
Pages
9
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
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).
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.
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.
Stress perfusion-CMR is safe, allows reliable ischemia detection, and provides good diagnostic value.
Keywords
Adenosine, Cardiovascular magnetic resonance, Implantable cardioverter defibrillator, Implantable device, MRI conditional, Pacemaker, Safety, Stress test
Pubmed
Web of science
Open Access
Yes
Create date
21/01/2022 17:18
Last modification date
25/07/2022 5:37
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