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. 2024 Nov 6;14(1):27006.
doi: 10.1038/s41598-024-73403-x.

Magnetic resonance-conditional cardiac implantable electronic devices: an Italian perspective on the prevalence of mixed-brand systems over time

Davide Saporito  1   2 , Eduardo Celentano  3 , Claudia Amellone  4 , Gabriele Zanotto  5 , Matteo Baroni  6 , Gennaro Miracapillo  7 , Mauro Biffi  8 , Valeria Calvi  9 , Lorenzo Spighi  10 , Antonio Curnis  11 , Ennio Carmine Luigi Pisanò  12 , Giovanni Rovaris  13 , Gaetano Senatore  14 , Fabrizio Caravati  15 , Francesca Notarangelo  16 , Massimiliano Marini  17 , Francesco Solimene  18 , Marcello Piacenti  19 , Luca Tomasi  20 , Luca Bontempi  21 , Gerardo Nigro  22 , Luca Poggio  23 , Stefano Pedretti  24 , Marzia Giaccardi  25 , Paolo Pastori  26 , Enrica Talini  27 , Giampiero Maglia  28 , Irene Baldassarre  29 , Daniele Giacopelli  29 , Alessio Gargaro  29 , Massimo Giammaria  4
Affiliations

Magnetic resonance-conditional cardiac implantable electronic devices: an Italian perspective on the prevalence of mixed-brand systems over time

Davide Saporito et al. Sci Rep. .

Abstract

The historical restriction of magnetic resonance imaging (MRI) for patients with cardiac implantable electronic devices (CIEDs) has been lifted by certified MRI-conditional systems in recent years. Mixed-brand CIED systems consisting of a generator from one manufacturer and at least one lead from another manufacturer are not certified for MRI. We evaluated the temporal trend in the prevalence of mixed-brand systems in the era of MRI-conditional systems. Data were analyzed on 5853 CIEDs implanted de novo between 2012 and 2022 in 81 Italian centers linked to the nationwide Home Monitoring Expert Alliance network. The percentage of mixed-brand implants was calculated by device type (pacemaker, implantable cardioverter-defibrillator [ICD], cardiac resynchronization therapy [CRT] device) and over time. A mixed-brand system was implanted in 4.1% (95% CI, 3.6-4.6%) of analyzed patients or, by device type, in 4.5% (3.5-5.7%) of pacemaker patients, 1.1% (0.7-1.7%) of ICD patients, and 6.8% (5.7-7.9%) of CRT pacemaker/defibrillator patients (p < 0.001). Prevalence of mixed-brand implants exhibited significant temporal fluctuations, first declining from 6.6% (2012-2014) to 1.3% (2019), and then increasing to 5.1% (2022). Temporal changes were statistically significant for pacemakers (p < 0.001) and CRT devices (p = 0.001), but not for ICDs (p = 0.438). In the decade between 2012 and 2022, mixed-brand CIED systems were more prevalent in patients treated with pacemakers and CRT devices than in ICD recipients. A decline in the prevalence of mixed-brand systems was observed after the introduction of MRI-conditional systems, reaching a minimum in 2019, followed by a progressive increase in the subsequent years.

Keywords: Cardiac implantable electronic devices; Implantable cardioverter-defibrillator; MRI-conditional; Magnetic resonance imaging; Pacemaker.

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Conflict of interest statement

Irene Baldasserre, Daniele Giacopelli and Alessio Gargaro are employees of BIOTRONIK Italia.

Figures

Fig. 1
Fig. 1
Sample selection. CRT, cardiac resynchronization therapy; CRT-D, CRT defibrillator; CRT-P, CRT pacemaker; DX ICD, single-lead ICD with atrial sensing capability and no atrial pacing capability; ICD, implantable cardioverter-defibrillator; PM, pacemaker.
Fig. 2
Fig. 2
Proportion of patients with a mixed-brand implant by device type (χ² test p < 0.001). CRT, cardiac resynchronization therapy device; ICD, implantable cardioverter-defibrillator; PM, pacemaker.
Fig. 3
Fig. 3
Proportion of patients with mixed-brand implants over time.
Fig. 4
Fig. 4
Proportion of patients with mixed-brand implants over time by device model. CRT, cardiac resynchronization therapy device; ICD, implantable cardioverter-defibrillator; PM, pacemaker.
See this image and copyright information in PMC

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