Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing: Results of the Evera MRI Study

Michael R. Gold, Torsten Sommer, Juerg Schwitter, Emanuel Kanal, Matthew A. Bernabei, Charles J. Love, Ralf Surber, Brian Ramza, Jeffrey Cerkvenik, B. Merkely

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Studies have shown that magnetic resonance imaging (MRI) conditional pacemakers experience no significant effect from MRI on device function, sensing, or pacing. More recently, similar safety outcomes were demonstrated with MRI conditional defibrillators (implantable cardioverter-defibrillator [ICD]), but the impact on ventricular arrhythmias has not been assessed. Objective The purpose of this study was to assess the effect of MRI on ICD sensing and treatment of ventricular tachyarrhythmias. Methods The Evera MRI Study was a worldwide trial of 156 patients implanted with an ICD designed to be MRI conditional. Device-detected spontaneous and induced ventricular tachycardia/ventricular fibrillation (VT/VF) episodes occurring before and after whole body MRI were evaluated by a blinded episode review committee. Detection delay was computed as the sum of RR intervals of undersensed beats. A ≥5-second delay in detection due to undersensing was prospectively defined as clinically significant. Results Post-MRI, there were 22 polymorphic VT/VF episodes in 21 patients, with 16 of these patients having 17 VT/VF episodes pre-MRI. Therapy was successful for all episodes, with no failures to treat or terminate arrhythmias. The mean detection delay due to undersensing pre- and post-MRI was 0.60 ± 0.59 and 0.33 ± 0.63 seconds, respectively (P = .17). The maximum detection delay was 2.19 seconds pre-MRI and 2.87 seconds post-MRI. Of the 17 pre-MRI episodes, 14 (82%) had some detection delay as compared with 11 of 22 (50%) post-MRI episodes (P = .03); no detection delay was clinically significant. Conclusion Detection and treatment of VT/VF was excellent, with no detection delays or significant impact of MRI observed.

Original languageEnglish
Pages (from-to)1631-1635
Number of pages5
JournalHeart Rhythm
Volume13
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

Fingerprint

Tachycardia
Magnetic Resonance Imaging
Ventricular Fibrillation
Ventricular Tachycardia
Implantable Defibrillators
Cardiac Arrhythmias
Equipment and Supplies
Defibrillators
Advisory Committees
Therapeutics

Keywords

  • Implantable cardioverter-defibrillator
  • Magnetic resonance imaging
  • Ventricular arrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing : Results of the Evera MRI Study. / Gold, Michael R.; Sommer, Torsten; Schwitter, Juerg; Kanal, Emanuel; Bernabei, Matthew A.; Love, Charles J.; Surber, Ralf; Ramza, Brian; Cerkvenik, Jeffrey; Merkely, B.

In: Heart Rhythm, Vol. 13, No. 8, 01.08.2016, p. 1631-1635.

Research output: Contribution to journalArticle

Gold, MR, Sommer, T, Schwitter, J, Kanal, E, Bernabei, MA, Love, CJ, Surber, R, Ramza, B, Cerkvenik, J & Merkely, B 2016, 'Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing: Results of the Evera MRI Study', Heart Rhythm, vol. 13, no. 8, pp. 1631-1635. https://doi.org/10.1016/j.hrthm.2016.05.014
Gold, Michael R. ; Sommer, Torsten ; Schwitter, Juerg ; Kanal, Emanuel ; Bernabei, Matthew A. ; Love, Charles J. ; Surber, Ralf ; Ramza, Brian ; Cerkvenik, Jeffrey ; Merkely, B. / Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing : Results of the Evera MRI Study. In: Heart Rhythm. 2016 ; Vol. 13, No. 8. pp. 1631-1635.
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T1 - Impact of magnetic resonance imaging on ventricular tachyarrhythmia sensing

T2 - Results of the Evera MRI Study

AU - Gold, Michael R.

AU - Sommer, Torsten

AU - Schwitter, Juerg

AU - Kanal, Emanuel

AU - Bernabei, Matthew A.

AU - Love, Charles J.

AU - Surber, Ralf

AU - Ramza, Brian

AU - Cerkvenik, Jeffrey

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N2 - Background Studies have shown that magnetic resonance imaging (MRI) conditional pacemakers experience no significant effect from MRI on device function, sensing, or pacing. More recently, similar safety outcomes were demonstrated with MRI conditional defibrillators (implantable cardioverter-defibrillator [ICD]), but the impact on ventricular arrhythmias has not been assessed. Objective The purpose of this study was to assess the effect of MRI on ICD sensing and treatment of ventricular tachyarrhythmias. Methods The Evera MRI Study was a worldwide trial of 156 patients implanted with an ICD designed to be MRI conditional. Device-detected spontaneous and induced ventricular tachycardia/ventricular fibrillation (VT/VF) episodes occurring before and after whole body MRI were evaluated by a blinded episode review committee. Detection delay was computed as the sum of RR intervals of undersensed beats. A ≥5-second delay in detection due to undersensing was prospectively defined as clinically significant. Results Post-MRI, there were 22 polymorphic VT/VF episodes in 21 patients, with 16 of these patients having 17 VT/VF episodes pre-MRI. Therapy was successful for all episodes, with no failures to treat or terminate arrhythmias. The mean detection delay due to undersensing pre- and post-MRI was 0.60 ± 0.59 and 0.33 ± 0.63 seconds, respectively (P = .17). The maximum detection delay was 2.19 seconds pre-MRI and 2.87 seconds post-MRI. Of the 17 pre-MRI episodes, 14 (82%) had some detection delay as compared with 11 of 22 (50%) post-MRI episodes (P = .03); no detection delay was clinically significant. Conclusion Detection and treatment of VT/VF was excellent, with no detection delays or significant impact of MRI observed.

AB - Background Studies have shown that magnetic resonance imaging (MRI) conditional pacemakers experience no significant effect from MRI on device function, sensing, or pacing. More recently, similar safety outcomes were demonstrated with MRI conditional defibrillators (implantable cardioverter-defibrillator [ICD]), but the impact on ventricular arrhythmias has not been assessed. Objective The purpose of this study was to assess the effect of MRI on ICD sensing and treatment of ventricular tachyarrhythmias. Methods The Evera MRI Study was a worldwide trial of 156 patients implanted with an ICD designed to be MRI conditional. Device-detected spontaneous and induced ventricular tachycardia/ventricular fibrillation (VT/VF) episodes occurring before and after whole body MRI were evaluated by a blinded episode review committee. Detection delay was computed as the sum of RR intervals of undersensed beats. A ≥5-second delay in detection due to undersensing was prospectively defined as clinically significant. Results Post-MRI, there were 22 polymorphic VT/VF episodes in 21 patients, with 16 of these patients having 17 VT/VF episodes pre-MRI. Therapy was successful for all episodes, with no failures to treat or terminate arrhythmias. The mean detection delay due to undersensing pre- and post-MRI was 0.60 ± 0.59 and 0.33 ± 0.63 seconds, respectively (P = .17). The maximum detection delay was 2.19 seconds pre-MRI and 2.87 seconds post-MRI. Of the 17 pre-MRI episodes, 14 (82%) had some detection delay as compared with 11 of 22 (50%) post-MRI episodes (P = .03); no detection delay was clinically significant. Conclusion Detection and treatment of VT/VF was excellent, with no detection delays or significant impact of MRI observed.

KW - Implantable cardioverter-defibrillator

KW - Magnetic resonance imaging

KW - Ventricular arrhythmias

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