Schrittmacher und ICD in der Magnetresonanztomografie

Magnetfelder ziehen Metall an und stören die Elektrik – physikalische Grundprinzipien, die in der modernen Medizin zu großen Herausforderungen geführt haben. Elektrische Implantate wie Schrittmacher galten lange als absolute Kontraindikationen für Untersuchungen mit der Magnetresonanztomografie – doch die Zeiten haben sich, dank technischer Neuerungen, durchaus gewandelt.

Schlüsselwörter

Schrittmacher - ICD - MRT

• Literatur

• 1 Raatikainen MJP, Arnar DO, Merkely B. et al. A Decade of Information on the Use of Cardiac Implantable Electronic Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries: 2017 Report from the European Heart Rhythm Association. Europace 2017; 19: ii1-ii90 doi:10.1093/europace/eux258
• 2 Kalin R, Stanton MS. Current clinical issues for MRI scanning of pacemaker and defibrillator patients. Pacing Clin Electrophysiol 2005; 28: 326-328 doi:10.1111/j.1540-8159.2005.50024.x
• 3 Sommer T, Bauer W, Fischbach K. et al. MR Imaging in Patients with Cardiac Pacemakers and Implantable Cardioverter Defibrillators. Rofo 2017; 189: 204-217 doi:10.1055/s-0043-102029
• 4 Russo RJ, Costa HS, Silva PD. et al. Assessing the Risks Associated with MRI in Patients with a Pacemaker or Defibrillator. N Engl J Med 2017; 376: 755-764 doi:10.1056/NEJMoa1603265
• 5 Luechinger R, Duru F, Scheidegger MB. et al. Force and torque effects of a 1.5-Tesla MRI scanner on cardiac pacemakers and ICDs. Pacing Clin Electrophysiol 2001; 24: 199-205
• 6 Luechinger R, Duru F, Zeijlemaker VA. et al. Pacemaker reed switch behavior in 0.5, 1.5, and 3.0 Tesla magnetic resonance imaging units: are reed switches always closed in strong magnetic fields?. Pacing Clin Electrophysiol 2002; 25: 1419-1423
• 7 Luechinger R, Zeijlemaker VA, Pedersen EM. et al. In vivo heating of pacemaker leads during magnetic resonance imaging. Eur Heart J 2005; 26: 376-383 doi:10.1093/eurheartj/ehi009 discussion 325–377
• 8 Nordbeck P, Weiss I, Ehses P. et al. Measuring RF-induced currents inside implants: Impact of device configuration on MRI safety of cardiac pacemaker leads. Magn Reson Med 2009; 61: 570-578 doi:10.1002/mrm.21881
• 9 Shellock FG, Woods TO, Crues JV. MR labeling information for implants and devices: explanation of terminology. Radiology 2009; 253: 26-30 doi:10.1148/radiol.2531091030
• 10 Schwitter J, Gold MR, Al Fagih A. et al. Image Quality of Cardiac Magnetic Resonance Imaging in Patients With an Implantable Cardioverter Defibrillator System Designed for the Magnetic Resonance Imaging Environment. Circ Cardiovasc Imaging 2016; 9
• 11 Hilbert S, Weber A, Nehrke K. et al. 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 2018; 20: 801-807 doi:10.1093/europace/eux016
• 12 Stevens SM, Tung R, Rashid S. et al. Device artifact reduction for magnetic resonance imaging of patients with implantable cardioverter-defibrillators and ventricular tachycardia: late gadolinium enhancement correlation with electroanatomic mapping. Heart Rhythm 2014; 11: 289-298 doi:10.1016/j.hrthm.2013.10.032
• 13 Mesubi O, Ahmad G, Jeudy J. et al. Impact of ICD artifact burden on late gadolinium enhancement cardiac MR imaging in patients undergoing ventricular tachycardia ablation. Pacing Clin Electrophysiol 2014; 37: 1274-1283 doi:10.1111/pace.12405
• 14 Brignole M, Auricchio A, Baron-Esquivias G. et al. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J 2013; 34: 2281-2329 doi:10.1093/eurheartj/eht150
• 15 Sommer T, Vahlhaus C, Lauck G. et al. MR imaging and cardiac pacemakers: in-vitro evaluation and in-vivo studies in 51 patients at 0.5 T. Radiology 2000; 215: 869-879 doi:10.1148/radiology.215.3.r00jn08869
• 16 Irnich W, Irnich B, Bartsch C. et al. Do we need pacemakers resistant to magnetic resonance imaging?. Europace 2005; 7: 353-365 doi:10.1016/j.eupc.2005.02.120
• 17 Muehling OM, Wakili R, Greif M. et al. Immediate and 12 months follow up of function and lead integrity after cranial MRI in 356 patients with conventional cardiac pacemakers. J Cardiovasc Magn Reson 2014; 16: 39 doi:10.1186/1532-429X-16-39
• 18 Horwood L, Attili A, Luba F. et al. Magnetic resonance imaging in patients with cardiac implanted electronic devices: focus on contraindications to magnetic resonance imaging protocols. Europace 2017; 19: 812-817 doi:10.1093/europace/euw122
• 19 Naehle CP, Zeijlemaker V, Thomas D. et al. Evaluation of cumulative effects of MR imaging on pacemaker systems at 1.5 Tesla. Pacing Clin Electrophysiol 2009; 32: 1526-1535 doi:10.1111/j.1540-8159.2009.02570.x