Medical Summarization

🚀 MRI Scanning for Patients with Implanted S - ICD

This project focuses on the feasibility and safety of MRI scanning for patients with an implanted subcutaneous implantable cardioverter - defibrillator (S - ICD). It provides in - depth research and data analysis on the potential risks and practical applications of this combination.

🚀 Quick Start

The need for magnetic resonance imaging (MRI) in patients with an implanted pacemaker or implantable cardioverter - defibrillator (ICD) is a growing clinical issue. It's estimated that up to 75% of active cardiac device recipients will need an MRI. Currently, most such devices are contraindicated for MRI use.

✨ Features

• Safety Evaluation: This study assesses the safety of using MRI on patients with an implanted S - ICD, considering various potential hazards such as electrode heating, myocardial damage, and device malfunction.
• Clinical Data Collection: It collects detailed clinical data from 15 patients with implanted S - ICD systems, including patient anatomical data, scan locations, and noted clinical events.
• Protocol Design: The study uses specific MRI scanning protocols and sequences, and provides guidance on how to program the cardiac device before MRI exposure.

📚 Documentation

Patient Enrollment

• Patients with implanted S - ICD systems (Boston Scientific SqRx model 1010 and Q - trak model 3010) were enrolled over 18 months.
• Newly implanted S - ICD systems (< 6 weeks) were excluded, and no patients had intravascular leads.
• Patients were randomized for cardiac, brain, cervical, or lumbar spinal scans. One patient also had a knee examination due to chronic pain.

MRI Scanning

• A Siemens Avanto 1.5 T MRI scanner (VB17 software, quantum gradient coils) was used, running in normal operating mode with a 2 W/kg whole - body averaged specific absorption rate (SAR).
• Clinically relevant MRI sequences were used for evaluation, including FLAIR, DWI, FLASH, FSE, HASTE, SE, STIR, and TrueFISP.

Data Collection

• Patient anatomical data, scan locations, and clinical events were recorded in tables 1 and 2.
• S - ICD parameters and patient sensations during individual MRI scans were also collected.

Safety Measures

• Patients were asked to report any pain, torqueing movement, or heating sensation.
• An oesophageal temperature probe was taped on the skin over the implant site to record temperature changes.
• The S - ICD system was programmed to minimize the risk of inappropriate therapy, and its proper functioning was verified before and after the scan.

🔧 Technical Details

The use of MRI with most pacemakers and ICDs is contraindicated due to potential hazards. However, the S - ICD system, which has no leads touching the heart, may have different safety profiles. This study provides a single - centre prospective non - controlled analysis of the first use of MRI in patients with an implanted S - ICD. It details the specific scanning conditions, device programming requirements, and safety evaluation methods.

📄 License

This project is licensed under the Apache - 2.0 license.