4 years ago

Safety of Magnetic Resonance Imaging in Patients with Legacy Pacemakers and Defibrillators and Abandoned Leads

During magnetic resonance imaging (MRI), abandoned leads may act as antennae that result in tissue heating and arrhythmia induction. Objectives To assess the safety of MRI in patients with abandoned leads, with the addition of cardiac troponin T (CTnT) assessment to screen for myocardial damage. Methods We reviewed our prospectively collected database of patients with CIEDs undergoing MRI between 2008-2017 at Mayo Clinic, Rochester, Minnesota and selected patients who had abandoned leads.. We compared the adverse events in this population with an age, sex and site of MRI matched cohort of patients selected from this database. We evaluated paired (before/after) cTnT values with MRI in these patients. Results 80 out of 952 patients underwent 97 MRI scans with CIEDs in situ with 90 abandoned leads in place during the scans. The median age was 66 years (IQR 22.3 years) with 66.3% male. There was no clinical or electrical evidence of CIED dysfunction, arrhythmias or pain.. Paired samples for measurement of cTnT were available in 40 patients undergoing 44 MRI examinations. The mean difference between the pre-and post-imaging values was -0.002 + 0.006 ng/ml (IQR=0). There was no difference after adjustment for total number of leads per patient and total number of ICD coils . Conclusions There was no evidence of myocardial injury as measured by paired cTnT. The risk of MRI with abandoned leads appears low suggesting a favorable risk-benefit profile in CIED patients with abandoned leads who are considered for MRI.

Publisher URL: www.sciencedirect.com/science

DOI: S1547527117312365

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