Cardiovascular Magnetic Resonance Imaging in a Patient With Implanted Leadless Pacemaker

Löbe, Susanne; Hilbert, Sebastian; Hindricks, Gerhard; Jahnke, Cosima; Paetsch, Ingo

doi:10.1016/j.jacep.2017.07.009

Cited by 6 publications

(7 citation statements)

References 1 publication

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“…Whereas the Micra ® TPS is approved for 1.5 T as well as 3.0 T scanners, the Nanostim ® LCP is approved for 1.5 T scanners only. Ex vivo as well as real-life data confirmed the safety and feasibility of MRI scans with good image quality of even cardiac MRIs [36][37][38][39]. Specifically, pacing thresholds (changes vs. baseline 0.01 ± 0.05 V) and other device parameters remained stable [40], and device dislodgements have not been observed to be increased by MRI scans in LP systems [41].…”

Section: Magnetic Resonance Imaging (Mri) Compatibility Of Leadless Pmentioning

confidence: 53%

State of the art: leadless ventricular pacing

Steinwender

Lercher

Schukro

et al. 2019

J Interv Card Electrophysiol

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Background Cardiac pacing has been shown to improve quality of life and prognosis of patients with bradycardia for almost 60 years. The latest innovation in pacemaker therapy was miniaturization of generators to allow leadless pacing directly in the right ventricle. There is a long history and extensive experience of leadless ventricular pacing in Austria. However, no recommendations of national or international societies for indications and implantation of leadless opposed to transvenous pacing systems have been published so far. Results A national expert panel of skilled implanters gives an overview on the two utilized leadless cardiac pacing systems and highlights clinical advantages as well as current knowledge of performance and complication rates of leadless pacing. Furthermore, a national consensus for Austria is presented, based on recent studies and current know-how, specifically including indications for leadless pacing, management of infection, suggestions for qualification, and training of the operators and technical standards. Conclusions Leadless pacing systems can be implanted successfully with a low complication rate, if suggestions for indications and technical requirements are followed. Condensed abstract An overview of the two utilized leadless cardiac pacing systems is given, specifically highlighting clinical advantages as well as current knowledge of performance and complication rates. Furthermore, a national consensus for Austria is presented, specifically including indications for leadless pacing, management of infection, and suggestions for qualification and technical standards.

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Section: Magnetic Resonance Imaging (Mri) Compatibility Of Leadless Pmentioning

confidence: 53%

State of the art: leadless ventricular pacing

Steinwender

Lercher

Schukro

et al. 2019

J Interv Card Electrophysiol

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“…8 Only limited data exist for MRI in patients with preexisting leadless cardiac pacemakers; however, MRI scans in these patients have been reported as uneventful so far. 6,7,9,10 We complied with the recommended minimal postimplant time of 6 weeks before performing an MRI scan. Retrospectively, the elevated prescan pacing threshold may have indicated a suboptimal positioning of the tines, although anchorage of a minimum of two tines was proven.…”

Section: Discussionmentioning

confidence: 99%

Functional parameters impairment after MRI in a patient with a transcatheter pacing system

Kuffer

Steven

Bruck

et al. 2019

Magnetic Resonance Imaging

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“…Recently, Löbe et al. published a clinical case on cardiac MRI imaging in a patient carrying the other available device [24]. …”

Section: Introductionmentioning

confidence: 99%

Visualization and appearance of artifacts of leadless pacemaker systems in cardiac MRI

Edlinger

Granitz

Paar

et al. 2018

Wien Klin Wochenschr

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SummaryBackgroundLeadless pacemaker systems are an important upcoming device in clinical rhythmology. Currently two different products are available with the Micra system (Medtronic) being the most used in the clinical setting to date. The possibility to perform magnetic resonance imaging (MRI) is an important feature of modern pacemaker devices. Even though the Micra system is suitable for MRI, little is yet known about its impact on artifacts within the images.ObjectiveThe aim of our ex vivo study was to perform cardiac MRI to quantify the artifacts and to evaluate if artifacts limit or inhibit the assessment of the surrounding myocardium.MethodsAfter ex vivo implantation of the leadless pacemaker (LP) in a porcine model, hearts were filled with saline solution and fixed on wooden sticks on a plastic container. The model was examined at 1.5 T and at 3 T using conventional sequences and T2 mapping sequences. In addition, conventional X‑rays and computed tomography (CT) scans were performed.ResultsCorrect implantation of the LP could be performed in all hearts. In almost all MRI sequences the right ventricle and the septal region surrounding the (LP) were altered by an artifact and therefore would sustain limited assessment; however, the rest of the myocardium remained free of artifacts and evaluable for common radiologic diagnoses. A characteristic shamrock-shaped artifact was generated which appeared to be even more intense in magnitude and brightness when using 3 T compared to 1.5 T.ConclusionThe use of the Micra system in cardiac MRI appeared to be feasible. In our opinion, it will still be possible to make important clinical cardiac MRI diagnoses (the detection of major ischemic areas or inflammatory processes) in patients using the Micra system. We suggest the use of 1.5 T as the preferred method in clinical practice.

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Cardiovascular Magnetic Resonance Imaging in a Patient With Implanted Leadless Pacemaker

Cited by 6 publications

References 1 publication

State of the art: leadless ventricular pacing

State of the art: leadless ventricular pacing

Functional parameters impairment after MRI in a patient with a transcatheter pacing system

Visualization and appearance of artifacts of leadless pacemaker systems in cardiac MRI

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