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MR-Untersuchungen bei Patienten mit Herzschrittmachern und implantierbaren Kardioverter-Defibrillatoren : Konsensuspapier der Deutschen Gesellschaft fuer Kardiologie (DGK) und der Deutschen Roentgengesellschaft (DRG) [MRI examinations in patients with cardiac pacemakers and implantable cardioverter defibrilators : Consensus paper of the German Cardiac Society (DKG) and the German Roentgen Society (DRG)]

Item Type:Article
Title:MR-Untersuchungen bei Patienten mit Herzschrittmachern und implantierbaren Kardioverter-Defibrillatoren : Konsensuspapier der Deutschen Gesellschaft fuer Kardiologie (DGK) und der Deutschen Roentgengesellschaft (DRG) [MRI examinations in patients with cardiac pacemakers and implantable cardioverter defibrilators : Consensus paper of the German Cardiac Society (DKG) and the German Roentgen Society (DRG)]
Creators Name:Sommer, T. and Bauer, W. and Fischbach, K. and Kolb, C. and Luechinger, R. and Wiegand, U. and Lotz, J. and Eitel, I. and Gutberlet, M. and Thiele, H. and Schild, H.H. and Kelm, M. and Quick, H. and Schulz-Menger, J. and Barkhausen, J. and Baensch, D.
Abstract:This joint consensus paper of the German Roentgen Society and the German Cardiac Society describes the physical and electrophysiological background and provides specific recommendations for the procedural management of patients with cardiac pacemakers (PM) and implantable cardioverter defibrillators (ICD) undergoing magnetic resonance imaging (MRI). The paper outlines the responsibilities of radiologists and cardiologists regarding patients education, indications, monitoring, modification of MRI sequences and PM/ICD reprogramming strategies being discussed in particular. The aim is to optimize patient safety and to improve legal certainty in order to facilitate the access of SM/ICD-patient to MR imaging. The key message of this paper are as follows: 1. Conventional PM and ICD systems are no longer an absolute but rather a relavite contraindication for performing an MRI examination. Procedural management includes the assessment of the individual risk/benefit ratio, comprehensive patient informed consent about specific risks and "off label" use, extensive PM/ICD-related and MRI-related safety precautions to reduce these risks to the greatest extent possible, as well as adequate monitoring techniques. 2. MR conditional pacemaker and ICD system have been tested and approved for MRI examination under specific conditions ("interlabel" use). Precise understanding of and compliance with the terms of use for the specific pacemaker system are essential for patient safety. 3. The risk for an ICD patient during MRI examinations to be considered significantly higher compared to PM patients due to the higher vulnerability of the structural damaged myocardium and the higher risk of irreversible damage to conventional ICS systems. The indication for an MRI examination of an ICD patient should therefore be determinded on a stricter basis and the expected risk/benefit ratio should be critically reviewed. 4. This complex subject requires close collaboration between radiology and cardiology.
Keywords:MIR, Pacemaker, Defibrillator, ICD, MRI Safety
Source:Kardiologe
ISSN:1864-9718
Publisher:Springer (Germany)
Volume:11
Number:2
Page Range:97-113
Date:March 2017
Official Publication:https://doi.org/10.1007/s12181-017-0124-6

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