During up to 6 years of use in pediatric and CHD patients, the M3830 lead has demonstrated excellent efficacy, a low rate of complications, and straightforward extractability relative to traditional pacing leads.
Diagnostic quality MRI can be performed safely in nonpacemaker-dependent CHD patients with predominantly epicardial leads. Further studies will define safe practice measures in this population, as well as in CHD patients with pacemaker dependency.
Background: Heart Rhythm Society guidelines outlining magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices (CIEDs) excluded children and epicardial or abandoned leads due to theoretical risks of harm. Research investigating these risks is lacking. The primary objective of our study is to determine the incidence of adverse events to patients or CIEDs from MRI imaging. The secondary objective is to describe CIED-related artifact on MRI images. Methods: A single-center retrospective review was performed on all patients with CIEDs who underwent 1.5 Tesla MRI between July 2007 and May 2019. We subdivided patients among four cohorts: (1) patients <18 years of age, (2) epicardial leads, (3) abandoned endocardial leads, and (4) abandoned epicardial leads. Descriptive statistics pre-and post-MRI and at follow-up within 1.5 years were conducted. Results: Fifty-four MRIs were performed on 40 patients. Median age was 21.2 years (IQR 12.0-25.0). Eighteen (33%) MRIs contained abandoned leads; 20 (37%) contained epicardial leads. Three patients, one with abandoned epicardial leads and two with abandoned endocardial leads, experienced mild discomfort at the CIED site. One adult with endocardial leads experienced a pause in the heart rate while programmed in a nonpacing mode. No clinically important changes to CIED parameters occurred. Nine MRIs (17%), especially those with functional cardiac imaging, were uninterpretable due to image artifact. Conclusion: In this study, pediatric and adult CHD patients with CIEDs, many with epicardial or abandoned leads, underwent MRIs without clinically significant complications. In some, CIED artifact reduced cardiac MRI image quality due to CIED position.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.