磁共振兼容起搏器的临床应用

MRI-conditional pacemakers:clinical application

心血管植入性电子装置(cardiovascular implantable electronic devices,CIED)和磁共振扫描(magnetic resonance image,MRI)的临床应用逐年增加。50%~75%的CIED患者可能需要MRI检查。但由于MRI检查中的磁场和能量会导致电子装置不可逆的损害,因此,CIED患者一直是MRI扫描的禁忌。2009年,磁共振兼容起搏器被用于临床。与传统起搏器相比,磁共振兼容起搏器在脉冲发生器和电极导线构造方面都做了一系列改进,从而大大减少磁场对起搏系统的影响,使得患者可以安全地接受磁共振扫描。当然,随着临床应用增加,人们对磁共振兼容起搏器认识亟待提高。文章从磁场对起搏系统的影响,磁共振兼容起搏器构造的改进,不同制造商的磁共振兼容起搏器的特征以及磁共振兼容起搏器今后的发展进行综述,以提高临床对磁共振兼容起搏器的认识。

There is a growing population of patients with cardiovascular implantable electronic devices and a concomitant increase in the use of magnetic resonance(MR). About 50%-75% patients with pacemaker would need more than one time of MRI scan in their lifetime. But MRI scan was prohibited in pacemaker patients due to the potentially dangerous interactions between cardiac devices and the magnetic fields used in MRI. The MRI-conditional pacemakers were first introduced in 2009. Compared with conventional pacemaker, there is a series of modifications in generator and lead engineering in MRI-conditional pacemalcers, which is designed to minimize interactions that could compromise device function and patient safety. With the increasing application of this device, people need to know more about it. In this review,we discuss the potential risks of MRI in patients with electronic cardiac devices and present updated information regarding the features of MRI-conditional pacemakers and the different characteristics of MRI-conditional pacemaker by different manufactures, hoping to improve the clinical knowledge about it.