Abstract 14723: Safety and Outcomes of Magnetic Resonance Imaging in Patients With Abandoned Pacemaker and Defibrillator Leads
Introduction: Until recently, the presence of cardiac implantable electronic devices (CIEDs) was an absolute contraindication for diagnostic magnetic resonance imaging (MRI). There is now increasing recognition that MRI can be safely performed in patients with CIEDs under careful monitoring. The safety of MRI in patients with abandoned device leads is not known. Abandoned leads have remained a contraindication to MRI studies, due largely 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 prior to MRI, rendering the device leads abandoned. All patients who underwent device explantation at Mayo Clinic between 1990 and 2013 were cross-referenced to those scanned by MRI (with a 1.5T magnet) during the same time interval. A total of 15 pacemaker and 3 implantable cardioverter-defibrillator (ICD) patients underwent scanning with abandoned leads. Data collected included lead model, pacing threshold before MRI, anatomic region subjected to MRI examination, threshold data after generator reimplantation, and patient outcome.
Results: Patients (n=18, 11 men and 7 women) aged 19 to 85 at the time of MRI with a mean of 1.67abandoned leads at the time of imaging underwent a total of 31 scans, with most (28/31) being of the central nervous system. None of the leads were MRI conditional. There were no adverse events associated with MRI in these patients with abandoned leads within 7 days of the scan. In addition, among the 12 patients who had generators reimplanted with reuse of the abandoned leads, there were no lead malfunctions or clinically significant changes in capture threshold. Of the 3 ICD leads, two of three were dual coil.
Conclusion: The use of MRI in patients with abandoned cardiac device leads appears safe, 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.
- © 2013 by American Heart Association, Inc.