心脏植入式电子设备和计算机断层扫描成像在当前时代与幻影模型的干扰
Akihito Ideishi1,2, Kenichiro Yamagata1, Tatsuya Nishii3
1Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.
计算机断层扫描 (CT) 扫描对于心脏植入式电子设备 (CIED) 的患者来说通常是安全的. 虽然幻影研究中发生了一些过度传感,但临床上显著的不良事件很少发生,这表明常规设备重新编程通常是不必要的.
科学领域:
- 医疗成像医学成像
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 心脏植入式电子设备 (CIED) 管理心脏节律障碍.
- 计算机断层扫描 (CT) 辐射对于CIED患者是允许的,但报告的不良事件需要谨慎.
- 关于CT对近期CIED的影响的数据有限,这凸显了安全评估的必要性.
研究的目的:
- 为了评估与CT照射相关的不良事件,在CIED患者中.
- 在这一群体中确定CT手术所需和足够的安全措施.
- 评估CT照射对近期CIEDs的影响.
主要方法:
- 利用一个带有CIED的人形幻影模型来模拟CT照射.
- 监测设备电图,根据各种CT协议评估不良事件.
- 评估标准和最大剂量CT协议.
主要成果:
- 在标准CT协议中观察到高达3.2s的暂停时间的过度感应;没有确诊的临床显著事件.
- 在最大剂量方案中检测到过度感应,停顿时间高达8.0秒,心室动脉节律失常.
- 由于心室动脉节律不持续,没有引发任何设备治疗 (抗心节奏或休克).
结论:
- 具有临床意义的不良事件不太可能发生在接受CT照射的CIED患者中,使用当前的设置和协议进行CT照射.
- 大多数患者通常不需要在CT扫描前进行常规设备设置调整或监测.
- 进一步的研究可能会完善特定CIED类型和CT协议的安全协议.
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