A detailed view on pacemaker lead parameters remotely transmitted after magnetic resonance

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Medical Imaging

Background:

• Patients with permanent pacemakers (PMs) often require magnetic resonance imaging (MRI).
• MR-conditional PMs allow for MRI scans, but their effect on lead parameters needs evaluation.
• The ProMRI study investigated the safety of MR scans in patients with MR-conditional PMs.

Purpose of the Study:

• To analyze the influence of magnetic resonance (MR) on automatically assessed permanent pacemaker (PM) lead parameters.
• To evaluate remotely transmitted lead data in patients with MR-conditional PMs undergoing brain and lumbar spine MR (1.5T).

Main Methods:

• The ProMRI study used Evia PMs with Safio S leads, equipped with remote monitoring.
• Atrial (RA) and ventricular (RV) lead parameters (sensing, pacing capture threshold [PCT], pacing impedance) were automatically assessed and remotely transmitted for 3 months post-MR.
• Data were normalized using 1-month follow-up data, and confidence intervals were calculated using one-sample t-tests.

Main Results:

• A total of 2,428 datasets were transmitted, with no significant differences in lead parameters compared to pre-MR measurements.
• Mean sensing, PCT, and pacing impedance values remained stable across both RA and RV leads.
• No clinically significant increases in atrial or ventricular PCT were observed, with one exception possibly linked to amiodarone therapy.

Conclusions:

• Automatic assessment and remote transmission of PM lead parameters after MR indicate no clinically relevant impact.
• Sensing amplitudes, pacing capture thresholds, and pacing impedances are not adversely affected by MR exposure in MR-conditional PMs.
• Remote monitoring is a viable tool for tracking PM lead parameters in patients undergoing MR procedures.