Abstract:
BACKGROUND:Magnetic resonance imaging (MRI) is avoided in most patients with implanted cardiac devices because of safety concerns. OBJECTIVE:To define the safety of a protocol for MRI at the commonly used magnetic strength of 1.5 T in patients with implanted cardiac devices. DESIGN:Prospective nonrandomized trial. (ClinicalTrials.gov registration number: NCT01130896) SETTING: One center in the United States (94% of examinations) and one in Israel. PATIENTS:438 patients with devices (54% with pacemakers and 46% with defibrillators) who underwent 555 MRI studies. INTERVENTION:Pacing mode was changed to asynchronous for pacemaker-dependent patients and to demand for others. Tachyarrhythmia functions were disabled. Blood pressure, electrocardiography, oximetry, and symptoms were monitored by a nurse with experience in cardiac life support and device programming who had immediate backup from an electrophysiologist. MEASUREMENTS:Activation or inhibition of pacing, symptoms, and device variables. RESULTS:In 3 patients (0.7% [95% CI, 0% to 1.5%]), the device reverted to a transient back-up programming mode without long-term effects. Right ventricular (RV) sensing (median change, 0 mV [interquartile range {IQR}, -0.7 to 0 V]) and atrial and right and left ventricular lead impedances (median change, -2 Ω [IQR, -13 to 0 Ω], -4 Ω [IQR, -16 to 0 Ω], and -11 Ω [IQR, -40 to 0 Ω], respectively) were reduced immediately after MRI. At long-term follow-up (61% of patients), decreased RV sensing (median, 0 mV, [IQR, -1.1 to 0.3 mV]), decreased RV lead impedance (median, -3 Ω, [IQR, -29 to 15 Ω]), increased RV capture threshold (median, 0 V, IQR, [0 to 0.2 Ω]), and decreased battery voltage (median, -0.01 V, IQR, -0.04 to 0 V) were noted. The observed changes did not require device revision or reprogramming. LIMITATIONS:Not all available cardiac devices have been tested. Long-term in-person or telephone follow-up was unavailable in 43 patients (10%), and some data were missing. Those with missing long-term capture threshold data had higher baseline right atrial and right ventricular capture thresholds and were more likely to have undergone thoracic imaging. Defibrillation threshold testing and random assignment to a control group were not performed. CONCLUSION:With appropriate precautions, MRI can be done safely in patients with selected cardiac devices. Because changes in device variables and programming may occur, electrophysiologic monitoring during MRI is essential.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Nazarian S,Hansford R,Roguin A,Goldsher D,Zviman MM,Lardo AC,Caffo BS,Frick KD,Kraut MA,Kamel IR,Calkins H,Berger RD,Bluemke DA,Halperin HRdoi
10.7326/0003-4819-155-7-201110040-00004subject
Has Abstractpub_date
2011-10-04 00:00:00pages
415-24issue
7eissn
0003-4819issn
1539-3704pii
155/7/415journal_volume
155pub_type
临床试验,杂志文章,多中心研究abstract::Under the current system of disability determination and workers' compensation for occupational lung disease, disabled workers or their survivors can reasonably count on being compensated. However, by rejecting established scientific truth in order to pay workers' compensation in circumstances where disability or deat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-97-6-908
更新日期:1982-12-01 00:00:00
abstract::Meningitis caused by enteric gram-negative bacilli is relatively uncommon but is very difficult to treat despite susceptibility in vitro to many antimicrobics. A major problem appears to be poor entry of many drugs into the central nervous system. Moxalactam is an investigational cephalosporin that attains concentrati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-3-302
更新日期:1981-09-01 00:00:00
abstract:OBJECTIVE:To determine whether diabetic patients, when compared with nondiabetic patients, have a higher incidence of restenosis after coronary stenting, and, if so, whether restenosis is attributable to lesion or procedural differences or to a greater biologic tendency for late loss of minimum diameter in diabetic pat...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-118-5-199303010-00004
更新日期:1993-03-01 00:00:00
abstract::For an estimated 10 million trips abroad by U.S. residents in 2002, "visiting friends and relatives" (VFR) was a purpose for travel. Made up largely of foreign-born U.S. residents and their children, this population shows disparities in the number of reported cases of many preventable travel-related illnesses compared...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-142-1-200501040-00013
更新日期:2005-01-04 00:00:00
abstract:BACKGROUND:Because only limited evidence suggests that elastic stockings prevent the post-thrombotic syndrome in patients with symptomatic deep venous thrombosis (DVT), these stockings are not widely used. OBJECTIVE:To evaluate the efficacy of compression elastic stockings for prevention of the post-thrombotic syndrom...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-141-4-200408170-00004
更新日期:2004-08-17 00:00:00
abstract:BACKGROUND:Pulmonary embolism is a common clinical disorder that is associated with high morbidity and mortality if untreated. It is important to confirm or rule out the diagnosis in patients with clinical suspicion of the disease. PURPOSE:To evaluate various diagnostic strategies for excluding pulmonary embolism. DA...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-138-12-200306170-00005
更新日期:2003-06-17 00:00:00
abstract::Disorders determined wholly or in part by genetic factors constitute a substantial number of human diseases. This realization has grown during the past 2 decades with the recognition of many specific heritable conditions and the identification of familial risk factors for common disorders. New technologies, such as fe...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
doi:10.7326/0003-4819-104-4-527
更新日期:1986-04-01 00:00:00
abstract::Immediately after the liberation of Kuwait by a coalition of allied forces in March 1991, representatives of Physicians for Human Rights traveled to Kuwait and conducted an inquiry into human rights violations allegedly perpetrated by Iraqi forces. The inquiry focused on the abuses that were said to have occurred in h...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-117-1-78
更新日期:1992-07-01 00:00:00
abstract:PURPOSE:To review the status of emergency, urgent, routine, and selective angiography after intravenous thrombolytic therapy. DATA SOURCES:Relevant English-language articles published from January 1985 to July 1990 were identified through MEDLINE. STUDY SELECTION:For emergency angiography, four major randomized studi...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-114-10-877
更新日期:1991-05-15 00:00:00
abstract:BACKGROUND:Medical students may be at high risk for occupational exposures to blood. OBJECTIVE:To measure the frequency of medical students' exposure to infectious body substances, to identify factors that affect the probability of such exposure, and to suggest targets for the prevention of such exposure. DESIGN:Revi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-1-199901050-00009
更新日期:1999-01-05 00:00:00
abstract::A patient with familial Mediterranean fever and amyloidosis who received a cadaver renal transplant 6 1/2 years ago was studied to determine the relation of the serum precursor of secondary amyloid (SAA) to the clinical course and to the deposition of amyloid in the transplant. Amyloid fibrils extracted from the patie...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-87-1-31
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:Reviews have compared the efficacy and tolerability of newer second-generation antidepressants with those of placebo or older treatments, but comparative evidence for use of second-generation antidepressants to treat major depressive disorder has not been evaluated. PURPOSE:To systematically evaluate compar...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-143-6-200509200-00006
更新日期:2005-09-20 00:00:00
abstract:BACKGROUND:Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported. OBJECTIVE:To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A. DESIGN:Retrospective chart review. SETTING:15 acute care...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-128-2-199801150-00006
更新日期:1998-01-15 00:00:00
abstract::Treatment advances and outcomes data have raised new concerns about how to optimize care for patients with HIV infection. This paper reviews evidence on 1) the relation between experience and type of training and patient outcomes, 2) the relation between the components of primary care and patient outcomes, and 3) prim...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-131-2-199907200-00011
更新日期:1999-07-20 00:00:00
abstract:Background:Frailty assessment may inform surgical risk and prognosis not captured by conventional surgical risk scores. Purpose:To evaluate the evidence for various frailty instruments used to predict mortality, functional status, or major adverse cardiovascular and cerebrovascular events (MACCEs) in older adults unde...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M16-0652
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To determine the most effective and safe dose of enoxaparin to prevent deep venous thrombosis in high-risk surgical patients. DESIGN:A double-blind, randomized, multicenter clinical trial. SETTING:Private, university, and government hospitals in the United States. PATIENTS:572 patients having elective hip ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-121-2-199407150-00001
更新日期:1994-07-15 00:00:00
abstract::Folate deficiency is a frequent cause of anemia in alcoholics, but little attention has been paid to its prevention. Folic acid was readily soluble in wines of high ethanol content at concentrations of 10 microgram/ml. Lactobacillus casei folate activity of folic acid added to wines was well maintained during a month'...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-87-5-542
更新日期:1977-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the effectiveness of chemotherapy and adjunctive surgery in managing patients with advanced seminoma. DESIGN:Nonrandomized prospective clinical trial of chemotherapy in a cohort of patients with advanced seminoma. SETTING:Referral cancer hospital. PATIENTS:Consecutive sample of 62 patien...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-4-513
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To determine, through structured methodologic review of published articles, the effectiveness of short-course (< or = 2 weeks) antibiotic therapy for catheter-related Staphylococcus aureus bacteremia. DATA SOURCES:English-language publications on catheter-related S. aureus bacteremia identified using MEDLINE...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-119-4-199308150-00010
更新日期:1993-08-15 00:00:00
abstract::Two patients presenting with nephrotic syndrome but without evidence of collagen vascular disease had organized glomerular immune deposits with a "fingerprint" pattern. This finding has been previously associated with lupus nephritis and, in our institution, has been seen in 6% of the biopsy specimens from patients wi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-100-1-66
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:To evaluate whether a brief course of treatment with gallium nitrate can reduce biochemical parameters of accelerated bone turnover in patients with advanced Paget disease. DESIGN:Unblinded trial, decreasing dose schedules of gallium nitrate. SETTING:University hospital with primary orthopedic and metabolic...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-11-847
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Pay-for-performance (P4P) is increasingly touted as a means to improve health care quality. PURPOSE:To evaluate the effect of P4P remuneration targeting individual health care providers. DATA SOURCES:MEDLINE, EMBASE, Cochrane Library, OpenSIGLE, Canadian Evaluation Society Unpublished Literature Bank, New ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-157-12-201212180-00009
更新日期:2012-12-18 00:00:00
abstract::During a 4.4-year period, nonspecific interstitial pneumonitis was seen in 41 of 110 (38%) patients with the acquired immunodeficiency syndrome and accounted for 32% (48/152) of all episodes of clinical pneumonitis. Diffuse alveolar damage was typically a feature of nonspecific interstitial pneumonitis, but neither lu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-1-7
更新日期:1987-07-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the long-term benefit and side effects of danazol therapy, and to delineate factors influencing the responses in patients with autoimmune thrombocytopenia. DESIGN:Before and after trial. SETTING:Referral-based hematology clinics and the University of Miami teaching hospitals. PATIENTS:Data ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-9-723
更新日期:1989-11-01 00:00:00
abstract::The exocrine pancreas secretes into the gut on demand more than 20 proteins that are indispensable for digestion. In-vivo autodigestion is prevented by an array of natural safeguards. In acute pancreatitis, inappropriate intrapancreatic activation and release of pancreatic hydrolases occur, but the pathogenetic mechan...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-103-1-86
更新日期:1985-07-01 00:00:00
abstract::The earthquake that struck Haiti in January 2010 caused an estimated 230,000 deaths and injured approximately 250,000 people. The Israel Defense Forces Medical Corps Field Hospital was fully operational on site only 89 hours after the earthquake struck and was capable of providing sophisticated medical care. During th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-153-1-201007060-00253
更新日期:2010-07-06 00:00:00
abstract:BACKGROUND:The incidence of esophageal adenocarcinoma is increasing rapidly. Gastroesophageal reflux is a strong risk factor for this disease. The increase in incidence of esophageal adenocarcinoma coincided with the introduction of medications that promote reflux by relaxing the lower esophageal sphincter (LES), such ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-3-200008010-00007
更新日期:2000-08-01 00:00:00
abstract::Because of difficulties in antemortem diagnosis of systemic aspergillosis, a radioimmunoassay to an Aspergillus fumigatus carbohydrate was developed and evaluated in patients with mycotic or bacterial infections. Antigenemia was detected in sera obtained antemortem from four of seven patients with systemic aspergillos...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-6-793
更新日期:1980-06-01 00:00:00
abstract::Palliative care prioritizes symptom management and quality of life throughout the course of serious illness. Regardless of whether care is inpatient or outpatient, primary or subspecialty, a solid understanding of the basics of effective communication, symptom management, and end-of-life care is crucial. This article ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/AITC201803060
更新日期:2018-03-06 00:00:00
abstract:BACKGROUND:Although few retrospective studies of high altitude have reported that obesity might be associated with the development of acute mountain sickness (AMS), this association has not been studied prospectively. OBJECTIVE:To determine whether obesity is associated with the development of AMS. DESIGN:Obese and n...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-139-4-200308190-00007
更新日期:2003-08-19 00:00:00