ICD detection and treatment of arrhythmias not impacted by MRI

1. ICD detection and treatment of arrhythmias not impacted by MRI
Abstract: https://www.acpjournals.org/doi/10.7326/M22-2653
URL goes live when the embargo lifts
A cohort study of more than 600 persons with non-magnetic resonance imaging (MRI)-conditional implantable cardioverter defibrillators (ICDs) found that these ICDs still appropriately treated detected tachyarrhythmias after MRI. The findings are published in Annals of Internal Medicine.

Previous research has shown that MRI does not have clinically important effects on the device parameters of non–MRI-conditional ICDs. However, data on non–MRI-conditional ICD detection and treatment of arrhythmias after MRI are limited.

Researchers from Johns Hopkins Hospital conducted a prospective cohort study of 629 persons with non-MRI-conditional ICD devices after undergoing MRI. The authors found no direct evidence of ICD failure to deliver therapy. They note that a substantial patient population with non–MRI-conditional ICDs currently exists with continued inequities in access to clinically indicated MRI examinations, likely from continued perceived risks of MRI examinations in patients with these devices. The authors suggest that their study provides additional safety data for this patient population under a standardized imaging protocol.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author, Joshua Ra, MD, please email Joshua.ra@ucsf.edu.
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2. Mpox modeling suggests timely detection, isolation could prevent significant spread on college campuses
Abstract: https://www.acpjournals.org/doi/10.7326/M22-2734
URL goes live when the embargo lifts
A model of mpox transmission among students living on a college campus suggests that sustained transmission could be significantly reduced with timely detection and isolation on its own. The model also showed that preventative vaccination of the high-risk population could help limit the size and scope of outbreaks. The findings are published in Annals of Internal Medicine.

In spring and summer 2022, an outbreak of mpox occurred worldwide, largely confined to men who have sex with men. There was concern that mpox could break swiftly into congregate settings and populations with high levels of regular frequent physical contact, like university campus communities.

Researchers from Yale School of Public Health created a stochastic dynamic SEIR (susceptible, exposed but not infectious, infectious, or recovered) model of mpox transmission comprising 6,500 college students in both low- and high-risk mpox transmission groups. The model produced 1,000 simulations of mpox transmission. The authors found that the model estimated an 83 percent likelihood of sustained transmission, or 183 cases on average, if no detection and isolation efforts were implemented. However, in scenarios when detection and isolation were implemented for 20, 50, or 80 percent of cases, the average infections would fall to 117, 37, and 8, respectively. The number of average infections were further reduced in scenarios using both reactive and preemptive vaccination. According to the authors, because their model shows that simple interventions could be highly effective in reducing both the likelihood and the magnitude of potential outbreaks, planning for mpox offers few downsides for administrators.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author, Alexandra Savinkina, MSPH, you may contact her at Alexandra.savinkina@yale.edu.
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