Safety and outcomes of magnetic resonance imaging in patients with abandoned pacemaker and defibrillator leads

John V. Higgins, Joseph J. Gard, Seth H. Sheldon, Raul Emilio Espinosa, Christopher P. Wood, Joel P. Felmlee, Yong-Mei Cha, Samuel J Asirvatham, Connie Dalzell, Nancy Acker, Robert E. Watson, Paul Andrew Friedman

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Introduction Abandoned cardiovascular implantable electronic device (CIED) leads remain a contraindication to magnetic resonance imaging (MRI) studies, largely due to in vitro data showing endocardial heating secondary to the radiofrequency field. We tested the hypothesis that abandoned CIED leads do not pose an increased risk of clinical harm for patients undergoing MRI.

Methods This single-center retrospective study examined the outcomes of patients who had device generators removed before MRI, rendering the device leads abandoned. Information was gathered through chart review. Data collected included lead model, pacing threshold before MRI, anatomic region examined, threshold data after generator reimplantation, and clinical patient outcome.

Results Patients (n = 19, 11 men and eight women) ranged in age from 19 to 85 at the time of MRI. There was a mean of 1.63 abandoned leads at the time of imaging; none of the leads were MRI conditional. Of the three implantable cardioverter defibrillator (ICD) leads, two of three were dual coil. Most (31/35) of the scans performed were of the central nervous system, including head and spinal imaging. There were no adverse events associated with MRI in any of these patients with abandoned leads within 7 days of the scan. No lead malfunctions or clinically significant change in pacing thresholds were noted with generator reimplantation.

Conclusion The use of MRI in patients with abandoned cardiac device leads appears feasible when performed under careful monitoring, with no adverse events, although the experience is small. MRI did not affect the function of leads that were subsequently reconnected to a cardiac device.

Original languageEnglish (US)
Pages (from-to)1284-1290
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume37
Issue number10
DOIs
StatePublished - Oct 1 2014

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Defibrillators
Magnetic Resonance Imaging
Safety
Equipment and Supplies
Replantation
Patient Harm
Implantable Defibrillators
Heating
Central Nervous System
Retrospective Studies
Head

Keywords

  • cardiac pacemaker
  • implantable cardioverter defibrillator
  • magnetic resonance imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Safety and outcomes of magnetic resonance imaging in patients with abandoned pacemaker and defibrillator leads. / Higgins, John V.; Gard, Joseph J.; Sheldon, Seth H.; Espinosa, Raul Emilio; Wood, Christopher P.; Felmlee, Joel P.; Cha, Yong-Mei; Asirvatham, Samuel J; Dalzell, Connie; Acker, Nancy; Watson, Robert E.; Friedman, Paul Andrew.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 37, No. 10, 01.10.2014, p. 1284-1290.

Research output: Contribution to journalArticle

Higgins, John V. ; Gard, Joseph J. ; Sheldon, Seth H. ; Espinosa, Raul Emilio ; Wood, Christopher P. ; Felmlee, Joel P. ; Cha, Yong-Mei ; Asirvatham, Samuel J ; Dalzell, Connie ; Acker, Nancy ; Watson, Robert E. ; Friedman, Paul Andrew. / Safety and outcomes of magnetic resonance imaging in patients with abandoned pacemaker and defibrillator leads. In: PACE - Pacing and Clinical Electrophysiology. 2014 ; Vol. 37, No. 10. pp. 1284-1290.
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AU - Sheldon, Seth H.

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AU - Wood, Christopher P.

AU - Felmlee, Joel P.

AU - Cha, Yong-Mei

AU - Asirvatham, Samuel J

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AU - Acker, Nancy

AU - Watson, Robert E.

AU - Friedman, Paul Andrew

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N2 - Introduction Abandoned cardiovascular implantable electronic device (CIED) leads remain a contraindication to magnetic resonance imaging (MRI) studies, largely due to in vitro data showing endocardial heating secondary to the radiofrequency field. We tested the hypothesis that abandoned CIED leads do not pose an increased risk of clinical harm for patients undergoing MRI.Methods This single-center retrospective study examined the outcomes of patients who had device generators removed before MRI, rendering the device leads abandoned. Information was gathered through chart review. Data collected included lead model, pacing threshold before MRI, anatomic region examined, threshold data after generator reimplantation, and clinical patient outcome.Results Patients (n = 19, 11 men and eight women) ranged in age from 19 to 85 at the time of MRI. There was a mean of 1.63 abandoned leads at the time of imaging; none of the leads were MRI conditional. Of the three implantable cardioverter defibrillator (ICD) leads, two of three were dual coil. Most (31/35) of the scans performed were of the central nervous system, including head and spinal imaging. There were no adverse events associated with MRI in any of these patients with abandoned leads within 7 days of the scan. No lead malfunctions or clinically significant change in pacing thresholds were noted with generator reimplantation.Conclusion The use of MRI in patients with abandoned cardiac device leads appears feasible when performed under careful monitoring, with no adverse events, although the experience is small. MRI did not affect the function of leads that were subsequently reconnected to a cardiac device.

AB - Introduction Abandoned cardiovascular implantable electronic device (CIED) leads remain a contraindication to magnetic resonance imaging (MRI) studies, largely due to in vitro data showing endocardial heating secondary to the radiofrequency field. We tested the hypothesis that abandoned CIED leads do not pose an increased risk of clinical harm for patients undergoing MRI.Methods This single-center retrospective study examined the outcomes of patients who had device generators removed before MRI, rendering the device leads abandoned. Information was gathered through chart review. Data collected included lead model, pacing threshold before MRI, anatomic region examined, threshold data after generator reimplantation, and clinical patient outcome.Results Patients (n = 19, 11 men and eight women) ranged in age from 19 to 85 at the time of MRI. There was a mean of 1.63 abandoned leads at the time of imaging; none of the leads were MRI conditional. Of the three implantable cardioverter defibrillator (ICD) leads, two of three were dual coil. Most (31/35) of the scans performed were of the central nervous system, including head and spinal imaging. There were no adverse events associated with MRI in any of these patients with abandoned leads within 7 days of the scan. No lead malfunctions or clinically significant change in pacing thresholds were noted with generator reimplantation.Conclusion The use of MRI in patients with abandoned cardiac device leads appears feasible when performed under careful monitoring, with no adverse events, although the experience is small. MRI did not affect the function of leads that were subsequently reconnected to a cardiac device.

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