101
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Siontis KC, Kim HM, Sharaf Dabbagh G, Latchamsetty R, Stojanovska J, Jongnarangsin K, Morady F, Bogun FM. Association of preprocedural cardiac magnetic resonance imaging with outcomes of ventricular tachycardia ablation in patients with idiopathic dilated cardiomyopathy. Heart Rhythm 2017; 14:1487-1493. [DOI: 10.1016/j.hrthm.2017.06.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Indexed: 11/24/2022]
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102
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2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. Heart Rhythm 2017; 14:e503-e551. [PMID: 28919379 DOI: 10.1016/j.hrthm.2017.09.001] [Citation(s) in RCA: 718] [Impact Index Per Article: 102.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Indexed: 02/06/2023]
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103
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Kalb B, Indik JH, Ott P, Martin DR. MRI of patients with implanted cardiac devices. J Magn Reson Imaging 2017; 47:595-603. [PMID: 28776823 DOI: 10.1002/jmri.25824] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/20/2017] [Indexed: 11/06/2022] Open
Abstract
Cardiac implanted electronic devices (CIEDs) have historically been regarded as a contraindication for performing magnetic resonance imaging (MRI), limiting the availability of this exam for large numbers of patients who may have otherwise benefited from the unique diagnostic capabilities of MRI. Interactions between CIEDs and the magnetic field associated with MRI systems have been documented, and include potential effects on CIED function, lead heating, and force/torque on the generator. Several device manufacturers have developed "MR-Conditional" CIEDs with specific hardware and software design changes to optimize the device for the MR environment. However, a substantial body of evidence has been accumulating that suggests that MRI may be safely performed in patients with either conditional or nonconditional CIEDs. Institutional policies and procedures, including preexam screening and assessment by skilled electrophysiology personnel and intraexam monitoring, allow MRI to be safely performed in CIED patients, as evidenced by at least two, large multicenter prospective studies and multiple smaller, single-institution studies. Cross-departmental collaboration and a robust safety infrastructure at sites that perform MRI should allow for the safe imaging of CIED patients who have a clinical indication for the study, regardless of the conditionality status of the device. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:595-603.
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Affiliation(s)
- Bobby Kalb
- Department of Medical Imaging, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Julia H Indik
- Sarver Hear Center, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Peter Ott
- Sarver Hear Center, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Diego R Martin
- Department of Medical Imaging, University of Arizona College of Medicine, Tucson, Arizona, USA
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104
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Strom JB, Whelan JB, Shen C, Zheng SQ, Mortele KJ, Kramer DB. Safety and utility of magnetic resonance imaging in patients with cardiac implantable electronic devices. Heart Rhythm 2017; 14:1138-1144. [PMID: 28385671 PMCID: PMC5557369 DOI: 10.1016/j.hrthm.2017.03.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Off-label magnetic resonance imaging (MRI) for patients with cardiac implantable electrical devices has been limited owing to concerns about safety and unclear diagnostic and prognostic utility. OBJECTIVE The purpose of this study was to define major and minor adverse events with off-label MRI scans. METHODS We prospectively evaluated patients with non-MRI-conditional cardiac implantable electrical devices referred for MRI scans under a strict clinical protocol. The primary safety outcome was incidence of major adverse events (loss of pacing, inappropriate shock or antitachycardia pacing, need for system revision, or death) or minor adverse events (inappropriate pacing, arrhythmias, power-on-reset events, heating at the generator site, or changes in device parameters at baseline or at 6 months). RESULTS A total of 189 MRI scans were performed in 123 patients (63.1% [78] men; median age 70 ± 18.5 years; 56.9% [70] patients with implantable cardioverter-defibrillators; 33.3% [41] pacemaker-dependent patients) predominantly for brain or spinal conditions. A minority of scans (22.7% [43]) were performed for urgent or emergent indications. Major adverse events were rare: 1 patient with loss of pacing, no deaths, or system revisions (overall rate 0.5%; 95% confidence interval 0.01-2.91). Minor adverse events were similarly rare (overall rate 1.6%; 95% confidence interval 0.3-4.6). Nearly all studies (98.4% [186]) were interpretable, while 75.1% [142] were determined to change management according to the prespecified criteria. No clinically significant changes were observed in device parameters acutely after MRI or at 6 months as compared with baseline across all patient and device categories. CONCLUSION Off-label MRI scans performed under a strict protocol demonstrated excellent short- and medium-term safety while providing interpretable imaging that frequently influenced clinical care.
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Affiliation(s)
- Jordan B Strom
- Richard A. and Susan F. Smith Center for Cardiovascular Outcomes Research, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jill B Whelan
- Harvard Medical School, Boston, Massachusetts; Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Changyu Shen
- Richard A. and Susan F. Smith Center for Cardiovascular Outcomes Research, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | | | - Koenraad J Mortele
- Department of Radiology, Divisions of Abdominal Imaging and Body MRI, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Daniel B Kramer
- Richard A. and Susan F. Smith Center for Cardiovascular Outcomes Research, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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105
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Celentano E, Caccavo V, Santamaria M, Baiocchi C, Melissano D, Pisanò E, Gallo P, Polcino A, Arena G, Patanè S, Senatore G, Licciardello G, Padeletti L, Vado A, Giorgi D, Pecora D, Stella P, Anaclerio M, Guastaferro C, Giovannini T, Giacopelli D, Gargaro A, Maglia G. Access to magnetic resonance imaging of patients with magnetic resonance-conditional pacemaker and implantable cardioverter-defibrillator systems: results from the Really ProMRI study. Europace 2017; 20:1001-1009. [DOI: 10.1093/europace/eux118] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 04/06/2017] [Indexed: 11/14/2022] Open
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106
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Magnetic resonance imaging in patients with cardiac implantable electronic devices: a single-center prospective study. J Interv Card Electrophysiol 2017; 50:95-104. [DOI: 10.1007/s10840-017-0262-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022]
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107
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Korutz AW, Obajuluwa A, Lester MS, McComb EN, Hijaz TA, Collins JD, Dandamudi S, Knight BP, Nemeth AJ. Pacemakers in MRI for the Neuroradiologist. AJNR Am J Neuroradiol 2017; 38:2222-2230. [PMID: 28705821 DOI: 10.3174/ajnr.a5314] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cardiac implantable electronic devices are frequently encountered in clinical practice in patients being screened for MR imaging examinations. Traditionally, the presence of these devices has been considered a contraindication to undergoing MR imaging. Growing evidence suggests that most of these patients can safely undergo an MR imaging examination if certain conditions are met. This document will review the relevant cardiac implantable electronic devices encountered in practice today, the background physics/technical factors related to scanning these devices, the multidisciplinary screening protocol used at our institution for scanning patients with implantable cardiac devices, and our experience in safely performing these examinations since 2010.
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Affiliation(s)
- A W Korutz
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.)
| | - A Obajuluwa
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.)
| | - M S Lester
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.)
| | - E N McComb
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.)
| | - T A Hijaz
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.)
| | - J D Collins
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.)
| | - S Dandamudi
- Medicine, Division of Cardiology (S.D., B.P.K.)
| | - B P Knight
- Medicine, Division of Cardiology (S.D., B.P.K.)
| | - A J Nemeth
- From the Departments of Radiology (A.W.K., A.O., M.S.L., E.N.M., T.A.H., J.D.C., A.J.N.).,Neurology (A.J.N.), Northwestern University Feinberg School of Medicine, Chicago, Illinois
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108
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Mulpuru SK, Madhavan M, McLeod CJ, Cha YM, Friedman PA. Cardiac Pacemakers: Function, Troubleshooting, and Management: Part 1 of a 2-Part Series. J Am Coll Cardiol 2017; 69:189-210. [PMID: 28081829 DOI: 10.1016/j.jacc.2016.10.061] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/06/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023]
Abstract
Advances in cardiac surgery toward the mid-20th century created a need for an artificial means of stimulating the heart muscle. Initially developed as large external devices, technological advances resulted in miniaturization of electronic circuitry and eventually the development of totally implantable devices. These advances continue to date, with the recent introduction of leadless pacemakers. In this first part of a 2-part review, we describe indications, implant-related complications, basic function/programming, common pacemaker-related issues, and remote monitoring, which are relevant to the practicing cardiologist. We provide an overview of magnetic resonance imaging and perioperative management among patients with cardiac pacemakers.
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Affiliation(s)
- Siva K Mulpuru
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Malini Madhavan
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | | | - Yong-Mei Cha
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Paul A Friedman
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
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109
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Indik JH, Gimbel JR, Abe H, Alkmim-Teixeira R, Birgersdotter-Green U, Clarke GD, Dickfeld TML, Froelich JW, Grant J, Hayes DL, Heidbuchel H, Idriss SF, Kanal E, Lampert R, Machado CE, Mandrola JM, Nazarian S, Patton KK, Rozner MA, Russo RJ, Shen WK, Shinbane JS, Teo WS, Uribe W, Verma A, Wilkoff BL, Woodard PK. 2017 HRS expert consensus statement on magnetic resonance imaging and radiation exposure in patients with cardiovascular implantable electronic devices. Heart Rhythm 2017; 14:e97-e153. [DOI: 10.1016/j.hrthm.2017.04.025] [Citation(s) in RCA: 238] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Indexed: 11/16/2022]
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110
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Samar H, Yamrozik JA, Williams RB, Doyle M, Shah M, Bonnet CA, Biederman RWW. Diagnostic Value of MRI in Patients With Implanted Pacemakers and Implantable Cardioverter-Defibrillators Across a Cross Population: Does the Benefit Justify the Risk? A Proof of Concept Study. JACC Clin Electrophysiol 2017; 3:991-1002. [PMID: 29759724 DOI: 10.1016/j.jacep.2017.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/07/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The objective of this study was to assess the diagnostic usefulness of thoracic and nonthoracic magnetic resonance imaging (MRI) imaging in patients with implantable cardiac devices (permanent pacemaker or implantable cardioverter-defibrillators [ICDs]) to determine if there was a substantial benefit to patients with regard to diagnosis and/or management. BACKGROUND MRI is infrequently performed on patients with conventional pacemakers or ICDs. Multiple studies have documented the safety of MRI scans in patients with implanted devices, yet the diagnostic value of this approach has not been established. METHODS Evaluation data were acquired in 136 patients with implanted cardiac devices who underwent MRIs during a 10-year period at a single institution. Specific criteria were followed for all patients to objectively define if the diagnosis by MRI enhanced patient care; 4 questions were answered after scan interpretation by both MRI technologists and MRI physicians who performed the scan. 1) Did the primary diagnosis change? 2) Did the MRI provide additional information to the existing diagnosis? 3) Was the pre-MRI (tentative) diagnosis confirmed? 4) Did patient management change? If "Yes" was answered to any of the preceding questions, the MRI scan was considered to be of value to patient diagnosis and/or therapy. RESULTS In 97% (n = 132) of patients, MR added value to patient diagnosis and management. In 49% (n = 67) of patients, MRI added additional valuable information to the primary diagnosis, and in 30% (n = 41) of patients, MRI changed the principle diagnosis and subsequent management of the patient. No safety issues were encountered, and no adverse effects of undergoing the MRI scan were noted in any patient. CONCLUSIONS MRI in patients with implanted pacemakers and defibrillators added value to patient diagnosis and management, which justified the risk of the procedure.
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Affiliation(s)
- Huma Samar
- Division of Cardiology, Centre for Cardiac MRI, Allegheny General Hospital, Pittsburgh, Pennsylvania; Loma Linda Veterans Affairs Hospital, Loma Linda, California
| | - June A Yamrozik
- Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania
| | | | - Mark Doyle
- Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania
| | - Moneal Shah
- Division of Cardiology, Centre for Cardiac MRI, Allegheny General Hospital, Pittsburgh, Pennsylvania; Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania
| | - Christopher A Bonnet
- Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania; Division of Electrophysiology, Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania
| | - Robert W W Biederman
- Division of Cardiology, Centre for Cardiac MRI, Allegheny General Hospital, Pittsburgh, Pennsylvania; Gerald McGinnis Cardiovascular Institute, Pittsburgh, Pennsylvania.
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111
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112
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Poh PG, Liew C, Yeo C, Chong LR, Tan A, Poh A. Cardiovascular implantable electronic devices: a review of the dangers and difficulties in MR scanning and attempts to improve safety. Insights Imaging 2017. [PMID: 28624970 PMCID: PMC5519496 DOI: 10.1007/s13244-017-0556-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Abstract An increasing number of patients are being treated with cardiovascular implantable electronic devices (CIEDs), many of which are MR conditional. There is a lack of literature on the safe scanning of MR conditional CIEDs. This review article discusses MR imaging safety in patients with implanted CIEDs. Guidelines on safe use and indications of imaging patients with MR conditional CIEDs are described, followed by a pictorial essay of the radiographic features of these devices. We also discuss the challenges of monitoring the patient in the MR environment, advances in MRI conditional imaging of devices, availability, limitations and workflow including vendor-specific and other collaborative efforts to simplify the scanning process. Radiologists must be able to facilitate the safe utilization of MR imaging in patients who have CIEDs. A thorough knowledge of the hazards of imaging non-MR compatible devices is required as well as knowing how to correctly identify and manage the imaging of patients with MR conditional CIEDs. Finally, we propose steps required to facilitate the safe scanning of patients with MR conditional CIEDs adopted in our institution and a contingency plan in the event that an inadvertent MR scan of a patient with a MRI unsafe CIED should occur. Main Messages • Risks of MR imaging in patients who have CIEDs have been worked around. • There are many technical limitations in enabling safe MR scanning of CIEDs. • Radiological identification of MRI-conditional status of CIEDs is useful. • Standardizing conditions for safe MRI scanning is important. • We offer example algorithms for facilitating safe MRI scanning of CIEDs.
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Affiliation(s)
- Pei Ghim Poh
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore. .,Singhealth Radiology Residency, 167 Jalan Bukit Merah #17-10 Tower 5, Singapore, 150167, Singapore.
| | - Charlene Liew
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Colin Yeo
- Department of Cardiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Le Roy Chong
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Andrew Tan
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Angeline Poh
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
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113
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Kim J, Hwang J, Choi JH, Choi HI, Kim MS, Jung SH, Nam GB, Choi KJ, Lee JW, Kim YH, Kim JJ. Frequency and clinical impact of retained implantable cardioverter defibrillator lead materials in heart transplant recipients. PLoS One 2017; 12:e0176925. [PMID: 28464008 PMCID: PMC5413001 DOI: 10.1371/journal.pone.0176925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/08/2017] [Indexed: 12/31/2022] Open
Abstract
End-stage heart failure patients with implantable cardioverter-defibrillator (ICD) with/without cardiac resynchronization therapy (CRT-D) often require heart transplantation (HTPL) as a last-resort treatment. We aimed to assess the frequency and clinical impact of retained ICD lead materials in HTPL patients. In this retrospective single center study, we examined the clinical records and chest radiographs of patients with ICD and CRT-D who underwent HTPL between January 1992 and July 2014. Of 40 patients with ICD and CRT-D at HTPL, 19 (47.5%) patients had retained ICD lead materials within the central venous system. Retained ICD lead materials following HTPL were more frequently noted in patients with longer implantation durations until HTPL. None of the patients underwent extraction procedures after HTPL. All patients were asymptomatic and did not exhibit significant complications or death related to the retained ICD lead materials. Seven (7/40, 17.5%) patients without any retained ICD lead materials underwent magnetic resonance imaging (MRI) during the follow-up period (median, 29.5 months); none of the patients with retained lead materials were given MRI. Considering the common use of MRI in HTPL patients, further studies on the prophylactic extraction of retained ICD lead materials and safety of MRI in these patients are needed.
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Affiliation(s)
- Jun Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jongmin Hwang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Hee Choi
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo-In Choi
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Seok Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Ho Jung
- Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Byoung Nam
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee-Joon Choi
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - You-Ho Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Joong Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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114
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GIMBEL JROD. Off-Label MRI in 2017 of CIEDs: A Daily “Fork-in-the Road” for Implanters and the Case for Common Sense. Pacing Clin Electrophysiol 2017; 40:463-466. [DOI: 10.1111/pace.13056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 01/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- J. ROD GIMBEL
- Columbia-St. Mary's Hospital; Cardiology; Milwaukee Wisconsin
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115
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Hilbert S, Weber A, Nehrke K, Börnert P, Schnackenburg B, Oebel S, Spampinato R, Rogge C, Richter S, Hindricks G, Paetsch I, Jahnke C. Artefact-free late gadolinium enhancement imaging in patients with implanted cardiac devices using a modified broadband sequence: current strategies and results from a real-world patient cohort. Europace 2017; 20:801-807. [DOI: 10.1093/europace/eux016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 01/17/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sebastian Hilbert
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Alexander Weber
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Kay Nehrke
- Philips Research Laboratories, Hamburg, Germany
| | | | | | - Sabrina Oebel
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Ricardo Spampinato
- Department of Cardiac Surgery, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Cathleen Rogge
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Sergio Richter
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Gerhard Hindricks
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Ingo Paetsch
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Cosima Jahnke
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
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116
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SHAH ANANDD, PATEL ADARSHU, KNEZEVIC ANDREA, HOSKINS MICHAELH, HIRSH DAVIDS, MERCHANT FAISALM, EL CHAMI MIKHAELF, DELURGIO DAVIDB, PATEL ANSHULM, LEON ANGELR, LANGBERG JONATHANJ, LLOYD MICHAELS. Clinical Performance of Magnetic Resonance Imaging Conditional and Nonconditional Cardiac Implantable Electronic Devices. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:467-475. [DOI: 10.1111/pace.13060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/29/2017] [Accepted: 02/11/2017] [Indexed: 12/01/2022]
Affiliation(s)
- ANAND D. SHAH
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | | | - ANDREA KNEZEVIC
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics; Emory University; Atlanta Georgia
| | - MICHAEL H. HOSKINS
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | - DAVID S. HIRSH
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | - FAISAL M. MERCHANT
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | - MIKHAEL F. EL CHAMI
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | - DAVID B. DELURGIO
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | - ANSHUL M. PATEL
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | - ANGEL R. LEON
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
| | | | - MICHAEL S. LLOYD
- Division of Cardiology; Emory University School of Medicine; Atlanta Georgia
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117
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Cardiac Implantable Electric Devices: Indications and Complications. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2017. [DOI: 10.1007/s40138-017-0128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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118
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Okamura H, Padmanabhan D, Watson RE, Dalzell C, Acker N, Jondal M, Romme AL, Cha YM, Asirvatham SJ, Felmlee JP, Friedman PA. Magnetic Resonance Imaging in Nondependent Pacemaker Patients with Pacemakers and Defibrillators with a Nearly Depleted Battery. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:476-481. [PMID: 28169434 DOI: 10.1111/pace.13042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 01/17/2017] [Accepted: 01/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) in patients with non-MRI-conditional cardiac implantable electronic devices (CIEDs) has been shown to be safe when performed under closely monitored protocols. However, the safety of MRI in patients with devices with a nearly depleted battery has not been reported. METHODS Prospective data were collected between January 2008 and May 2015 in patients with non-MRI-conditional CIEDs undergoing clinically indicated MRI under institutional protocol. Patients who were pacemaker dependent were excluded. Patients whose devices were at elective replacement indicator (ERI) at the time of MRI or close to ERI (ERI or replacement for battery depletion within 3 months of scan) were identified through database review and analyzed for clinical events. RESULTS MRI scans (n = 569) were performed in 442 patients. Of these, we identified 13 scans performed with a nearly depleted battery in nine patients. All scans with implantable cardioverter defibrillators (ICDs, n = 9) were uneventful. However, two scans with pacemakers close to ERI resulted in a power-on-reset (PoR) event. One scan with a pacemaker close to ERI that was programmed to DOO mode reached ERI during MRI and automatically changed to VVI mode. Additionally, one scan with a pacemaker at ERI did not allow programming. All pacemakers with events were implanted before 2005. CONCLUSION Patients with pacemakers and ICDs with a nearly depleted battery can safely undergo MRI when patients are not pacemaker dependent. Attention should be paid because old devices can result in PoR or ERI during MRI, which may lead to oversensing and inhibition of pacing.
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Affiliation(s)
- Hideo Okamura
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | | | - Robert E Watson
- Division of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota
| | - Connie Dalzell
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Nancy Acker
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Mary Jondal
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Abby L Romme
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Yong-Mei Cha
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | | | - Joel P Felmlee
- Division of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota
| | - Paul A Friedman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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Burchill LJ, Huang J, Tretter JT, Khan AM, Crean AM, Veldtman GR, Kaul S, Broberg CS. Noninvasive Imaging in Adult Congenital Heart Disease. Circ Res 2017; 120:995-1014. [DOI: 10.1161/circresaha.116.308983] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/17/2017] [Accepted: 02/17/2017] [Indexed: 11/16/2022]
Abstract
Multimodality cardiovascular imaging plays a central role in caring for patients with congenital heart disease (CHD). CHD clinicians and scientists are interested not only in cardiac morphology but also in the maladaptive ventricular responses and extracellular changes predisposing to adverse outcomes in this population. Expertise in the applications, strengths, and pitfalls of these cardiovascular imaging techniques as they relate to CHD is essential. The purpose of this article is to provide an overview of cardiovascular imaging in CHD. We focus on the role of 3 widely used noninvasive imaging techniques in CHD—echocardiography, cardiac magnetic resonance imaging, and cardiac computed tomography. Consideration is given to the common goals of cardiac imaging in CHD, including assessment of structural and residual heart disease before and after surgery, quantification of ventricular volume and function, stress imaging, shunt quantification, and tissue characterization. Extracardiac imaging is highlighted as an increasingly important aspect of CHD care.
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Affiliation(s)
- Luke J. Burchill
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Jennifer Huang
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Justin T. Tretter
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Abigail M. Khan
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Andrew M. Crean
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Gruschen R. Veldtman
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Sanjiv Kaul
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
| | - Craig S. Broberg
- From the Knight Cardiovascular Institute (L.J.B., A.M.K., S.K., C.S.B.), Doernbecher Children’s Hospital (J.H.), Oregon Health and Science University, Portland; The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH (J.T.T., G.R.V.); Department of Cardiology, Heart Lung and Vascular Institute, University of Cincinnati Medical Center, OH (A.M.C.); Department of Cardiology, Cincinnati Children’s Hospital, OH (A.M.C.); Department of Cardiology (A.M.C.) and Joint Department of Medical
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Cruypeninck Y, Dubourg B, Michelin P, Godin B, Savoye-Collet C, Gérardin E, Dacher JN. Pacemakers and MRI: A protocol in line with international guidelines and approved by the SFICV (French Society of Cardiovascular Imaging). Diagn Interv Imaging 2017; 98:203-215. [DOI: 10.1016/j.diii.2016.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/12/2016] [Accepted: 06/13/2016] [Indexed: 10/20/2022]
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Russo RJ, Costa HS, Silva PD, Anderson JL, Arshad A, Biederman RWW, Boyle NG, Frabizzio JV, Birgersdotter-Green U, Higgins SL, Lampert R, Machado CE, Martin ET, Rivard AL, Rubenstein JC, Schaerf RHM, Schwartz JD, Shah DJ, Tomassoni GF, Tominaga GT, Tonkin AE, Uretsky S, Wolff SD. Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator. N Engl J Med 2017; 376:755-764. [PMID: 28225684 DOI: 10.1056/nejmoa1603265] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverter-defibrillator (ICD) that was "non-MRI-conditional" (i.e., not approved by the Food and Drug Administration for MRI scanning). METHODS Patients in the registry were referred for clinically indicated nonthoracic MRI at a field strength of 1.5 tesla. Devices were interrogated before and after MRI with the use of a standardized protocol and were appropriately reprogrammed before the scanning. The primary end points were death, generator or lead failure, induced arrhythmia, loss of capture, or electrical reset during the scanning. The secondary end points were changes in device settings. RESULTS MRI was performed in 1000 cases in which patients had a pacemaker and in 500 cases in which patients had an ICD. No deaths, lead failures, losses of capture, or ventricular arrhythmias occurred during MRI. One ICD generator could not be interrogated after MRI and required immediate replacement; the device had not been appropriately programmed per protocol before the MRI. We observed six cases of self-terminating atrial fibrillation or flutter and six cases of partial electrical reset. Changes in lead impedance, pacing threshold, battery voltage, and P-wave and R-wave amplitude exceeded prespecified thresholds in a small number of cases. Repeat MRI was not associated with an increase in adverse events. CONCLUSIONS In this study, device or lead failure did not occur in any patient with a non-MRI-conditional pacemaker or ICD who underwent clinically indicated nonthoracic MRI at 1.5 tesla, was appropriately screened, and had the device reprogrammed in accordance with the prespecified protocol. (Funded by St. Jude Medical and others; MagnaSafe ClinicalTrials.gov number, NCT00907361 .).
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Affiliation(s)
- Robert J Russo
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Heather S Costa
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Patricia D Silva
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Jeffrey L Anderson
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Aysha Arshad
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Robert W W Biederman
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Noel G Boyle
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Jennifer V Frabizzio
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Ulrika Birgersdotter-Green
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Steven L Higgins
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Rachel Lampert
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Christian E Machado
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Edward T Martin
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Andrew L Rivard
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Jason C Rubenstein
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Raymond H M Schaerf
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Jennifer D Schwartz
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Dipan J Shah
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Gery F Tomassoni
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Gail T Tominaga
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Allison E Tonkin
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Seth Uretsky
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
| | - Steven D Wolff
- From the Scripps Research Institute (R.J.R.), the La Jolla Cardiovascular Research Institute (R.J.R., P.D.S.), University of California, San Diego (U.B.-G.), and Scripps Memorial Hospital (S.L.H., G.T.T.), La Jolla, the University of California, Los Angeles, Los Angeles (N.G.B.), and Providence St. Joseph Medical Center, Burbank (R.H.M.S.) - all in California; the Department of Entomology, University of Arizona, Tucson (H.S.C.); Intermountain Medical Center, Salt Lake City (J.L.A., A.E.T.); Inova Heart and Vascular Institute, Falls Church, VA (A.A.); Allegheny General Hospital, Pittsburgh (R.W.W.B.), and Abington Memorial Hospital, Abington (J.V.F.) - both in Pennsylvania; Yale University School of Medicine, New Haven, CT (R.L.); Providence Heart Institute, Southfield, MI (C.E.M.); Oklahoma Heart Institute, Tulsa (E.T.M.); University of Mississippi Medical Center, Jackson (A.L.R.); Medical College of Wisconsin, Milwaukee (J.C.R.); Bassett Medical Center, Cooperstown (J.D.S.), and Advanced Cardiovascular Imaging, Carnegie Hill Radiology, New York (S.U., S.D.W.) - both in New York; Methodist DeBakey Heart and Vascular Center, Houston (D.J.S.); and Baptist Health, Lexington, KY (G.F.T.)
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MR-Untersuchungen bei Patienten mit Herzschrittmachern und implantierbaren Kardioverter‑Defibrillatoren. KARDIOLOGE 2017. [DOI: 10.1007/s12181-017-0124-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Krebsbach A, Dewland TA, Henrikson CA. Malfunction of an MRI-Conditional Pacemaker Following an MRI. HeartRhythm Case Rep 2017; 3:148-150. [PMID: 28491791 PMCID: PMC5420058 DOI: 10.1016/j.hrcr.2016.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Affiliation(s)
| | | | - Charles A. Henrikson
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon
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Dandamudi S, Collins JD, Carr JC, Mongkolwat P, Rahsepar AA, Tomson TT, Verma N, Arora R, Chicos AB, Kim SS, Lin AC, Passman RS, Knight BP. The Safety of Cardiac and Thoracic Magnetic Resonance Imaging in Patients with Cardiac Implantable Electronic Devices. Acad Radiol 2016; 23:1498-1505. [PMID: 27717762 DOI: 10.1016/j.acra.2016.08.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/16/2016] [Accepted: 08/16/2016] [Indexed: 12/26/2022]
Abstract
RATIONALE AND OBJECTIVES Studies reporting the safety of magnetic resonance imaging (MRI) in patients with a cardiac implantable electronic device (CIED) have mostly excluded examinations with the device in the magnet isocenter. The purpose of this study was to describe the safety of cardiac and thoracic spine MRI in patients with a CIED. MATERIALS AND METHODS The medical records of patients with a CIED who underwent a cardiac or thoracic spine MRI between January 2011 and December 2014 were reviewed. Devices were interrogated before and after imaging with reprogramming to asynchronous pacing in pacemaker-dependent patients. The clinical interpretability of the MRI and peak and average specific absorption rates (SARs, W/kg) achieved were determined. RESULTS Fifty-eight patients underwent 51 cardiac and 11 thoracic spine MRI exams. Twenty-nine patients had a pacemaker and 29 had an implantable cardioverter defibrillator. Seventeen percent (n = 10) were pacemaker dependent. Fifty-one patients (89%) had non-MRI-conditional devices. There were no clinically significant changes in atrial and ventricular sensing, impedance, and threshold measurements. There were no episodes of device mode changes, arrhythmias, therapies delivered, electrical reset, or battery depletion. One study was prematurely discontinued due to a patient complaint of chest pain of which the etiology was not determined. Across all examinations, the average peak SAR was 2.0 ± 0.85 W/kg with an average SAR of 0.35 ± 0.37 W/kg. Artifact significantly limiting the clinical interpretation of the study was present in 33% of cardiac MRI studies. CONCLUSIONS When a comprehensive CIED magnetic resonance safety protocol is followed, the risk of performing 1.5-T magnetic resonance studies with the device in the magnet isocenter, including in patients who are pacemaker dependent, is low.
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Cadieu R, Peron M, Le Ven F, Kerdraon S, Boutet C, Mansourati J, Ben Salem D. Central nervous system MRI and cardiac implantable electronic devices. J Neuroradiol 2016; 44:1-9. [PMID: 27814887 DOI: 10.1016/j.neurad.2016.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/13/2016] [Indexed: 11/16/2022]
Abstract
As the population ages and indications for MRI increase, it is estimated that 50 to 75% of patients with a cardiac implantable electronic device (CIED) - pacemaker (PM) or implanted cardiac defibrillator (ICD) - will need an MRI during their CIED's lifetime. Three categories of materials are defined: MRI compatible, MRI non-compatible, and MRI conditional. MRI compatible CIEDs without electrodes have been developed, but do not allow battery changes, so that they are exclusively indicated for patients whose life expectancy is less than that of the battery (6-7years). For MRI conditional CIEDs, all manufacturers publish restrictions. These restrictions can relate to the patient (size, position in the MRI, body temperature), the MRI parameters (magnetic field), or the examination in itself (gradients, specific absorption rate, duration, isocenter). The neuroradiologist can expect to be confronted with the issue of MRI in patients with a CIED. The purpose of this review is to provide them with updated information on MRI and CIEDs.
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Affiliation(s)
- Romain Cadieu
- Neuroradiology department, University Hospital of Brest, LaTIM, Inserm UMR 1101, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - Marilyne Peron
- Neuroradiology department, University Hospital of Brest, LaTIM, Inserm UMR 1101, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - Florent Le Ven
- Cardiology department, University Hospital of Brest, ORPHY, EA 4324, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - Sébastien Kerdraon
- Neuroradiology department, University Hospital of Brest, LaTIM, Inserm UMR 1101, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - Claire Boutet
- Radiology department, University Hospital of Saint-Étienne, North hospital, Inserm U1059, avenue Albert-Raimond, 42055 Saint-Étienne cedex 2, France.
| | - Jacques Mansourati
- Cardiology department, University Hospital of Brest, ORPHY, EA 4324, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - Douraied Ben Salem
- Neuroradiology department, University Hospital of Brest, LaTIM, Inserm UMR 1101, boulevard Tanguy-Prigent, 29609 Brest cedex, France
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Applications of Advanced Imaging in Cardiac Electrophysiology. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2016; 18:66. [DOI: 10.1007/s11936-016-0491-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Miller JD, Nazarian S, Halperin HR. Implantable Electronic Cardiac Devices and Compatibility With Magnetic Resonance Imaging. J Am Coll Cardiol 2016; 68:1590-8. [DOI: 10.1016/j.jacc.2016.06.068] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/15/2016] [Accepted: 06/17/2016] [Indexed: 11/24/2022]
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Advancements in technology for patients with congenital heart disease: Implantable rhythm devices. PROGRESS IN PEDIATRIC CARDIOLOGY 2016. [DOI: 10.1016/j.ppedcard.2016.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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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. AJR Am J Roentgenol 2016; 207:599-604. [DOI: 10.2214/ajr.16.16033] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Corzani A, Ziacchi M, Biffi M, Allaria L, Diemberger I, Martignani C, Bratten T, Gardini B, Boriani G. Clinical management of electromagnetic interferences in patients with pacemakers and implantable cardioverter-defibrillators: review of the literature and focus on magnetic resonance conditional devices. J Cardiovasc Med (Hagerstown) 2016; 16:704-13. [PMID: 26313816 DOI: 10.2459/jcm.0000000000000301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The number of cardiac implantable electronic devices (CIEDs) has greatly increased in the last 10 years. Many electronic devices used in daily activities generate electromagnetic interferences (EMIs) that can interact with CIEDs. In clinical practice, it is very important to know the potential sources of EMIs and their effect on CIEDs in order to understand how to manage or mitigate them. A very important source of EMI is magnetic resonance (MR), which is considered nowadays the diagnostic gold standard for different anatomical districts. In this review, we focused on the effects of EMI on CIEDs and on the clinical management. Moreover, we made a clarification about MR and CIEDs.In patients with CIEDs, EMIs may cause potentially serious and even life-threatening complications (inappropriate shocks, device malfunctions, inhibition of pacing in pacemaker-dependent patients) and may rarely dictate device replacement. The association of inappropriate shocks with increased mortality highlights the importance of minimizing the occurrence of EMI. Adequate advice and recommendations about the correct management of EMIs in patients with CIEDs are required to avoid all complications during hospitalization and in daily life. Furthermore, the article focused on actual management about MR and CIEDs.
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Affiliation(s)
- Alessandro Corzani
- aDepartment of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, S.Orsola Malpighi University Hospital, Bologna, Italy bMedtronic Inc, Minneapolis, Minnesota, USA *These authors contributed equally to this work
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Abdelghani M, Soliman OI, Schultz C, Vahanian A, Serruys PW. Adjudicating paravalvular leaks of transcatheter aortic valves: a critical appraisal. Eur Heart J 2016; 37:2627-44. [DOI: 10.1093/eurheartj/ehw115] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 03/01/2016] [Indexed: 12/18/2022] Open
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Shao J, Rashid S, Renella P, Nguyen KL, Hu P. Myocardial T1 mapping for patients with implanted cardiac devices using wideband inversion recovery spoiled gradient echo readout. Magn Reson Med 2016; 77:1495-1504. [PMID: 27018872 DOI: 10.1002/mrm.26223] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 01/15/2016] [Accepted: 02/28/2016] [Indexed: 01/20/2023]
Abstract
PURPOSE To develop and validate a technique for myocardial T1 mapping in patients with implantable cardioverter defibrillators (ICDs). METHODS A MOLLI-based pulse sequence, named Wideband-FLASH-MOLLI, was developed by incorporating a fast low angle shot (FLASH) readout and a wideband inversion pulse. The performance of Wideband-FLASH-MOLLI was evaluated using phantom studies and validated in eight healthy volunteers and ten patients with ICDs at 1.5 Tesla. Comparisons were made between Wideband-FLASH-MOLLI, FLASH-MOLLI, and bSSFP-MOLLI sequences. RESULTS In phantom studies, the maximum T1 estimation errors using Wideband-FLASH-MOLLI with and without an ICD were less than 3% for T1 range from 212 to 1673 ms. In all healthy volunteers, there was no significant native myocardial T1 estimation difference using Wideband-FLASH-MOLLI before and after the external attachment of an ICD to the body coil (1178 ± 27 ms versus 1174 ± 33 ms; P = 0.41). Due to the presence of an ICD, the magnitude images acquired using bSSFP-MOLLI and FLASH-MOLLI showed severe artifacts within the myocardium. In contrast, no or negligible device-induced artifacts were noted within the myocardial regions of the healthy volunteers or the patients with ICDs when using Wideband-FLASH-MOLLI. CONCLUSION This study demonstrates the feasibility of using Wideband-FLASH-MOLLI to mitigate image artifacts and to produce accurate myocardial T1 maps in patients with ICDs. Magn Reson Med 77:1495-1504, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jiaxin Shao
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Shams Rashid
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Pierangelo Renella
- Department of Radiology, Ronald Reagan-UCLA Medical Center, California, USA.,Irvine College of Medicine, Irvine, California, USA
| | - Kim-Lien Nguyen
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Division of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Peng Hu
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,Biomedical Physics Inter-Departmental Graduate Program, University of California, Los Angeles, California, USA
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Jiménez A, Olaya A, Morales N, Sánchez J. Capítulo 14. Utilidad del mapeo tridimensional en la ablación de taquicardia ventricular en pacientes con miocardiopatía hipertrófica, taquicardia ventricular catecolaminérgica y síndrome de Brugada. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2016.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Villegas F, Gómez C. Capítulo 13. Utilidad del mapeo tridimensional de arritmias ventriculares en cardiopatía de origen no isquémico. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2016.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Mavrogeni SI, Poulos G, Sfikakis PP, Kitas GD, Kolovou G, Theodorakis G. Is there a place for cardiovascular magnetic resonance conditional devices in systemic inflammatory diseases? Expert Rev Cardiovasc Ther 2016; 14:677-82. [DOI: 10.1586/14779072.2016.1154458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
Since the first implant in 1980, implantable cardioverter defibrillator (ICD) technology has progressed rapidly. Modern ICD's have hundreds of programmable options with the general goal of preventing inappropriate shocks and providing shocks for truly life threatening symptomatic ventricular arrhythmias. New studies on ICD programming have shown the benefits of prolonged detection intervals in reaching this goal. Anti-tachycardia pacing (ATP) therapy has become an important adjunct to defibrillator shocks. Remote monitoring technologies have surfaced which have been shown to identify arrhythmias and problems with the device in an expedient fashion. The subcutaneous ICD offers the advantage of avoiding intravascular leads and their inherent risks. Lastly, the current understanding of the effects of MRI in ICD patients has advanced creating new opportunities to provide MRI safely to such patients.
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Affiliation(s)
- John Rickard
- a Department of Cardiovascular Medicine , Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic Foundation , Cleveland , OH , USA
| | - Bruce L Wilkoff
- a Department of Cardiovascular Medicine , Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic Foundation , Cleveland , OH , USA
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Kaasalainen T, Kivistö S, Holmström M, Peltonen J, Pakarinen S, Hänninen H, Sipilä O. Cardiac MRI in patients with cardiac pacemakers: practical methods for reducing susceptibility artifacts and optimizing image quality. Acta Radiol 2016; 57:178-87. [PMID: 25766728 DOI: 10.1177/0284185115574873] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/03/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) of pacemaker patients has become available despite of previous contraindications. However, pacing systems containing ferromagnetic material may hamper the diagnostic quality of cardiac MR (CMR) images. PURPOSE To study methods for reducing susceptibility-based artifacts in CMR examinations of pacemaker patients. MATERIAL AND METHODS Altogether 16 patients were scanned with 1.5T MRI scanner using cine balanced steady-state free-precession (bSSFP) and spoiled gradient echo (SPGR) sequences. The use of frequency-scout was also evaluated. For myocardial late gadolinium-enhanced (LGE) imaging, SPGR or bSSFP readout inversion-recovery prepared gradient echo sequences were used with and without phase-sensitive inversion-recovery (PSIR). Two radiologists subjectively compared the image quality (IQ) and the ranges of susceptibility artifacts were evaluated objectively. RESULTS The IQ proved adequate for diagnosing each patient, although in a few patients with a left-side implanted generator, artifacts hampered IQ in the anterior and anteroseptal segments of the myocardium in bSSFP cine and LGE sequences. In bSSFP cine, the use of frequency-scout could often transfer the banding artifacts away from the left ventricular myocardium. In LGE imaging, the artifacts were more pronounced in IR-bSSFP and PSIR than in IR-SPGR sequences. The ranges of generator-based artifacts were greater in bSSFP (10-12 cm) than in SPGR (6 cm) sequences due to banding artifacts. CONCLUSION The artifacts caused by pacemakers typically did not compromise the diagnostic IQ. The use of frequency-scout prior to bSSFP cine or the use of SPGR-based sequences could also improve IQ.
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Affiliation(s)
- Touko Kaasalainen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Sari Kivistö
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Miia Holmström
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Peltonen
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Biomedical Engineering and Computational Science, School of Science, Aalto University, Helsinki, Finland
| | - Sami Pakarinen
- Heart and Lung Center, Division of Cardiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Helena Hänninen
- Heart and Lung Center, Division of Cardiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Sipilä
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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138
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Cardiac MRI in patients with complex CHD following primary or secondary implantation of MRI-conditional pacemaker system. Cardiol Young 2016; 26:306-14. [PMID: 25704274 DOI: 10.1017/s1047951115000190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In patients with CHD, cardiac MRI is often indicated for functional and anatomical assessment. With the recent introduction of MRI-conditional pacemaker systems, cardiac MRI has become accessible for patients with pacemakers. The present clinical study aims to evaluate safety, susceptibility artefacts, and image reading of cardiac MRI in patients with CHD and MRI-conditional pacemaker systems. Material and methods CHD patients with MRI-conditional pacemaker systems and a clinical need for cardiac MRI were examined with a 1.5-T MRI system. Lead function was tested before and after MRI. Artefacts and image readings were evaluated using a four-point grading scale. RESULTS A total of nine patients with CHD (mean age 34.0 years, range 19.5-53.6 years) received a total of 11 cardiac MRI examinations. Owing to clinical indications, seven patients had previously been converted from conventional to MRI-conditional pacemaker systems. All MRI examinations were completed without adverse effects. Device testing immediately after MRI and at follow-up showed no alteration of pacemaker device and lead function. Clinical questions could be addressed and answered in all patients. CONCLUSION Cardiac MRI can be performed safely with high certainty of diagnosis in CHD patients with MRI-conditional pacemaker systems. In case of clinically indicated lead and box changing, CHD patients with non-MRI-conditional pacemaker systems should be considered for complete conversion to MRI-conditional systems.
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139
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Is It Possible for a Patient With a Pacemaker to Undergo MRI? AJR Am J Roentgenol 2016; 206:230. [DOI: 10.2214/ajr.15.15696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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140
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Njeim M, Bogun F. Selecting the Appropriate Ablation Strategy: the Role of Endocardial and/or Epicardial Access. Arrhythm Electrophysiol Rev 2015; 4:184-8. [PMID: 26835123 DOI: 10.15420/aer.2015.4.3.184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 10/27/2015] [Indexed: 11/04/2022] Open
Abstract
Percutaneous catheter ablation has emerged as an effective treatment modality for the management of ventricular tachycardia. Despite years of progress in this field, the role of epicardial mapping and ablation needs to be further refined. In this review, we discuss the relationship between the type of underlying heart disease and the location of the arrythmogenic substrate as it pertains to a procedural approach. We describe the contribution of preprocedural and intraprocedural diagnostic tools for the localisation of the arrhythmogenic substrate, with a special emphasis on cardiac MRI and electrophysiological mapping. In our opinion, the preferred approach to target ventricular tachycardia should depend on the patient's underlying heart disease and the location of scar tissue, which can be best visualised using cardiac MRI.
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141
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NJEIM MARIO, YOKOKAWA MIKI, FRANK LUBA, CRAWFORD THOMAS, GOOD ERIC, MORADY FRED, BOGUN FRANK. Value of Cardiac Magnetic Resonance Imaging in Patients With Failed Ablation Procedures for Ventricular Tachycardia. J Cardiovasc Electrophysiol 2015; 27:183-9. [DOI: 10.1111/jce.12848] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 09/02/2015] [Accepted: 09/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- MARIO NJEIM
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
| | - MIKI YOKOKAWA
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
| | - LUBA FRANK
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
| | - THOMAS CRAWFORD
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
| | - ERIC GOOD
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
| | - FRED MORADY
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
| | - FRANK BOGUN
- Division of Cardiovascular Medicine and the Department of Radiology; University of Michigan; Ann Arbor Michigan USA
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142
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GIMBEL JROD, PASSMAN ROD, KANAL EMANUEL. MRI Conditional Devices, Safety, and Access: Choose Wisely and When You Come to the Fork in the Road, Take It. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 38:1373-6. [DOI: 10.1111/pace.12751] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- J. ROD GIMBEL
- Department of Cardiology, Case Western Reserve-University Hospitals; Harrington Heart and Vascular Institute; Cleveland Ohio
| | - ROD PASSMAN
- Department of Cardiology; Northwestern University Feinberg School of Medicine, the Bluhm Cardiovascular Center, Chicago; Illinois
| | - EMANUEL KANAL
- Department of Radiology; University of Pittsburgh Medical Center; Pittsburgh Pennsylvania
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143
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Cardiac troponin T in patients with cardiac implantable electronic devices undergoing magnetic resonance imaging. J Interv Card Electrophysiol 2015; 45:91-7. [DOI: 10.1007/s10840-015-0064-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 09/29/2015] [Indexed: 11/24/2022]
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144
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Clinical safety of the Iforia implantable cardioverter-defibrillator system in patients subjected to thoracic spine and cardiac 1.5-T magnetic resonance imaging scanning conditions. Heart Rhythm 2015; 12:2155-61. [DOI: 10.1016/j.hrthm.2015.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Indexed: 11/17/2022]
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145
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Tanawuttiwat T, Nazarian S, Calkins H. The role of catheter ablation in the management of ventricular tachycardia. Eur Heart J 2015; 37:594-609. [DOI: 10.1093/eurheartj/ehv421] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/07/2015] [Indexed: 12/11/2022] Open
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146
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Savouré A, Mechulan A, Burban M, Olivier A, Lazarus A. The Kora Pacemaker is Safe and Effective for Magnetic Resonance Imaging. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 9:85-90. [PMID: 26327785 PMCID: PMC4536771 DOI: 10.4137/cmc.s24976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/20/2015] [Accepted: 04/28/2015] [Indexed: 11/05/2022]
Abstract
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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Affiliation(s)
| | | | - Marc Burban
- Nouvelles Cliniques Nantaises, Nantes, France
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147
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Abstract
Cardiac MR imaging has made major inroads in the new millennium in the diagnosis and assessment of prognosis for patients with cardiomyopathies. Imaging of left and right ventricular structure and function and tissue characterization with late gadolinium enhancement (LGE) as well as T1 and T2 mapping enable accurate diagnosis of the underlying etiology. In the setting of coronary artery disease, either transmurality of LGE or contractile reserve in response to dobutamine can assess the likelihood of recovery of function after revascularization. The presence of scar reduces the likelihood of a response to medical therapy and to cardiac resynchronization therapy in heart failure. The presence and extent of LGE relate to overall cardiovascular outcome in cardiomyopathies. A major role for cardiac MR imaging in cardiomyopathies is to identify myocardial scar for diagnostic and prognostic purposes.
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Affiliation(s)
- Christopher M Kramer
- Cardiovascular Imaging Center, University of Virginia Health System, Charlottesville, Virginia
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148
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Abstract
INTRODUCTION In inverse potential mapping, local epicardial potentials are computed from recorded body surface potentials (BSP). When BSP are recorded with only a limited number of electrodes, in general biophysical a priori models are applied to facilitate the inverse computation. This study investigated the possibility of deriving epicardial potential information using only 62 torso electrodes in the absence of an a priori model. METHODS Computer simulations were used to determine the optimal in vivo positioning of 62 torso electrodes. Subsequently, three different electrode configurations, i.e., surrounding the thorax, concentrated precordial (30 mm inter-electrode distance) and super-concentrated precordial (20 mm inter-electrode distance) were used to record BSP from three healthy volunteers. Magnetic resonance imaging (MRI) was performed to register the electrode positions with respect to the anatomy of the patient. Epicardial potentials were inversely computed from the recorded BSP. In order to determine the reconstruction quality, the super-concentrated electrode configuration was applied in four patients with an implanted MRI-conditional pacemaker system. The distance between the position of the ventricular lead tip on MRI and the inversely reconstructed pacing site was determined. RESULTS The epicardial potential distribution reconstructed using the super-concentrated electrode configuration demonstrated the highest correlation (R = 0.98; p < 0.01) with the original epicardial source model. A mean localization error of 5.3 mm was found in the pacemaker patients. CONCLUSION This study demonstrated the feasibility of deriving detailed anterior epicardial potential information using only 62 torso electrodes without the use of an a priori model.
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149
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Nazarian S, Reynolds MR, Ryan MP, Wolff SD, Mollenkopf SA, Turakhia MP. Utilization and likelihood of radiologic diagnostic imaging in patients with implantable cardiac defibrillators. J Magn Reson Imaging 2015; 43:115-27. [PMID: 26118943 PMCID: PMC4755166 DOI: 10.1002/jmri.24971] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 12/02/2022] Open
Abstract
Purpose To examine imaging utilization in a matched cohort of patients with and without implantable cardioverter defibrillators (ICD) and to project magnetic resonance imaging (MRI) utilization over a 10‐year period. Materials and Methods The Truven Health MarketScan Commercial claims and Medicare Supplemental health insurance claims data were used to identify patients with continuous health plan enrollment in 2009–2012. Patients with ICDs were identified using ICD‐9 and CPT codes, and matched to patients with the same demographic and comorbidity profile, but no record of device implantation. Diagnostic imaging utilization was compared across the matched cohorts, in total, by imaging categories, and in subpopulations of stroke, back pain, and joint pain. MRI use in the nonimplant group over the 4‐year period was extrapolated out to 10 years for ICD‐indicated patients. Results A cohort of 18,770 matched patients were identified; average age 65.5 ± 13.38 and 21.9% female. ICD patients had significantly less MRI imaging (0.23 0.70 SD vs. 0.00 0.08 SD, P < 0.0001) than nonimplant patients. Among patients with records of stroke/transient ischemic attack (TIA) (ICD 5%, nonimplant 4%) and accompanying diagnostic imaging, 44% of nonimplant patients underwent MRI vs. 1% of ICD patients (P < 0.0001). Forecast models estimated that 53% to 64% of ICD‐eligible patients may require an MRI within 10 years. Conclusion MRI utilization is lower in ICD patients compared to nonimplant patients, yet the burden of incident stroke/TIA, back, and joint pain suggests an unmet need for MR‐conditional devices. J. MAGN. RESON. IMAGING 2016;43:115–127.
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Affiliation(s)
- Saman Nazarian
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Michael P Ryan
- CTI Clinical Trial and Consulting Services, Cincinnati, Ohio, USA
| | | | | | - Mintu P Turakhia
- Stanford University School of Medicine, Palo Alto VA Healthcare System, Palo Alto, California, USA
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150
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Full-Body MRI in Patients With an Implantable Cardioverter-Defibrillator. J Am Coll Cardiol 2015; 65:2581-2588. [DOI: 10.1016/j.jacc.2015.04.047] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 12/12/2022]
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