Jon-David Ethington

Real world MRI experience with nonconditional and conditional cardiac rhythm devices after MagnaSafe

The recent MagnaSafe Registry demonstrated safety of nonthoracic magnetic resonance imaging (MRI) with nonconditional cardiac implantable electronic devices (CIEDs). However, independent validation and extension to thoracic MRIs are needed.

Implementation of a cardiac PET stress program: comparison of outcomes to the preceding SPECT era

BACKGROUND Cardiac positron emission testing (PET) is more accurate than single photon emission computed tomography (SPECT) at identifying coronary artery disease (CAD); however, the 2 modalities have not been thoroughly compared in a real-world setting. We conducted a retrospective analysis of 60-day catheterization outcomes and 1-year major adverse cardiovascular events (MACE) after the transition from a SPECT- to a PET-based myocardial perfusion imaging (MPI) program. METHODS MPI patients at Intermountain Medical Center from January 2011-December 2012 (the SPECT era, n = 6,777) and January 2014-December 2015 (the PET era, n = 7,817) were studied. Outcomes studied were 60-day coronary angiography, high-grade obstructive CAD, left main/severe 3-vessel disease, revascularization, and 1-year MACE-revascularization (MACE-revasc; death, myocardial infarction [MI], or revascularization >60 days). RESULTS Patients were 64 ± 13 years old; 54% were male and 90% were of European descent; and 57% represented a screening population (no prior MI, revascularization, or CAD). During the PET era, compared with the SPECT era, a higher percentage of patients underwent coronary angiography (13.2% vs. 9.7%, P < 0.0001), had high-grade obstructive CAD (10.5% vs. 6.9%, P < 0.0001), had left main or severe 3-vessel disease (3.0% vs. 2.3%, P = 0.012), and had coronary revascularization (56.7% vs. 47.1%, P = 0.0001). Similar catheterization outcomes were seen when restricted to the screening population. There was no difference in 1-year MACE-revasc (PET [5.8%] vs. SPECT [5.3%], P = 0.31). CONCLUSIONS The PET-based MPI program resulted in improved identification of patients with high-grade obstructive CAD, as well as a larger percentage of revascularization, thus resulting in fewer patients undergoing coronary angiography without revascularization. FUNDING This observational study was funded using internal departmental funds.

MYOCARDIAL STRESS FLOWS IN OBSTRUCTIVE CAD ARE HIGHER WITH REGADENOSON THAN DIPYRIDAMOLE

Cut-off myocardial blood flow values associated with clinically significant ischemia in patients undergoing PET/CT have been reported with dipyridamole. Little is reported on MBF in stenotic vessels ≥70% as compared to non-stenotic vessels using regadenoson and Rb82. 731 patients (482 males, 65

DIFFERENCES IN CORONARY FLOW RESERVES BY GENDER AND DIABETIC STATUS AS IDENTIFIED USING CARDIAC PET/CT

Existing literature is scarce regarding normal and abnormal measurements for coronary flow reserve (CFR) non-ischemic rubidium PET/CT cardiac stress perfusion scans using regadenoson as the stress agent. Here we analyze and compare global and vessel-specific CFR between diabetics (DM) and non-

How much heating is associated with magnetic resonance imaging in patients with pacemakers and implantable cardioverter defibrillators

Methods Methods: We tested the effect of MRI on local tissue heating over PM/ICD pulse generators (PGs) in a consecutive series of 34 non-thoracic scans in 30 patients (pts) enrolled in an ongoing registry study. MRI was performed with a General Electric 1.5 tesla model Signa HDXT scanner. Temperatures were taken immediately preand post-study with an infrared thermometer beamed at the center of the PG pocket and symmetrically on the opposite side of the anterior chest. Ambient temperature was set at 66°F. Pacing modes during MRI were 0D0 for intrinsic rates > 40 and D00 for rates < 40. Diffusion scan sequences were excluded in PM dependent pts. Devices were St. Jude (n = 11), Boston Scientific (n = 12) or Medtronic (n = 11). The primary endpoint was change in device-side versus control-side skin temperature.