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Monocenter feasibility study of the MRI compatibility of the Evia pacemaker in combination with Safio S pacemaker lead.

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance | 26 Sep 2012

CG Wollmann, E Steiner, P Vock, B Ndikung and H Mayr
Abstract
BACKGROUND: The purpose of this study was to evaluate the feasibility of the magnetic resonance (MR) conditional pacemaker (PM) system (Evia SR-T and DR-T with Safio S leads) under MR conditions. METHODS: Patients with standard PM indications and Evia PM were eligible for enrollment in this single center prospective non-randomized pilot study. Patients underwent MR of the brain and lower lumbar spine at 1.5 Tesla. Atrial (RA) und ventricular (RV) lead parameters (sensing, pacing threshold [PTH], pacing impedance) were assessed immediately before (baseline follow-up [FU]) and immediately after MRI (1st FU), after 1 month (2nd FU) and 3 months (3rd FU). The effect of MR on serious adverse device effect (SADE) free-rate, on atrial and ventricular sensing (AS/VS; mV) and atrial (RA) and ventricular (RV) pacing thresholds (PTH; V/0.4 ms) were investigated between baseline and 2nd FU. Continuous variables are expressed as mean +/- SD and were compared using paired Student’s t-test. A p < 0.05 was considered significant. RESULTS: Thirty-one patients were enrolled. One patient had to be excluded because of an enrollment violation. Therefore, data of 30 patients (female 12 [40%], age 73 +/- 12 years, dual chamber PM 15 [50%]) were included in this analysis. No MR related SADE occurred. Lead measurements were not statistically different between the baseline FU and the 2nd FU (AS/VS at baseline 3.2 +/- 2.1/15.0 +/- 6.0, at 2nd FU 3.2 +/- 2.1/14.9 +/- 6.5; p = ns. RA-PTH/RV-PTH at baseline 0.68 +/- 0.18/0.78 +/- 0.22, at 2nd FU 0.71 +/- 0.24/0.78 +/- 0.22; p = ns). The presence of the permanent pacemakers led to MR imaging artifacts on diffusion weighted sequences of the brain, but did not affect other sequences (e.g. FLAIR and T2 weighted spin-echo images). CONCLUSION: The use of the MR conditional Evia PM in a MR environment under predefined conditions is feasible. No MR related SADEs nor clinically relevant changes in device functions occurred.
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Concepts
Nuclear magnetic resonance, Transcutaneous pacing, Student's t-test, Statistics, Brain, Lumbar vertebrae, Magnetic resonance imaging, Artificial pacemaker
MeSH headings
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