Key result
Mixed-brand CIEDs comprise ~4% of implants, declining after MRI-conditional system introduction before progressively increasing.
Why the study?
Mixed-brand CIED systems are not certified for MRI, but the temporal trend in their prevalence during the MRI-conditional systems era had not been evaluated.
Does the availability of MRI-conditional devices and evolving safety evidence affect the prevalence of mixed-brand CIED implantations over time?
Observational (n=5,853)
Yes
Does the availability of MRI-conditional devices and evolving safety evidence affect the prevalence of mixed-brand CIED implantations over time?
The prevalence of mixed-brand CIED systems initially declined with the introduction of MRI-conditional devices but has recently increased, likely reflecting growing clinical confidence in the safety of MRI scans for patients with non-conditional devices.
Trends in mixed-brand CIED use may reflect evolving MRI safety perceptions; hypothesis-generating for device selection and compatibility studies.
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.
No takes yet. Share an insight, caveat, or question.
Saporito et al. (2024) conducted an observational in Cardiac implantable electronic devices (CIEDs) (n=5,853). Mixed-brand CIED systems vs. Single-brand CIED systems was evaluated on Prevalence of mixed-brand CIED systems (95% CI 3.6-4.6). Mixed-brand CIED systems were implanted in 4.1% of patients, with prevalence declining after the introduction of MRI-conditional systems to a minimum in 2019 before progressively increasing.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: