Impact of capped and uncapped abandoned leads on the heating of an MR‐conditional pacemaker implant

Mattei, Eugenio; Gentili, Giulia; Censi, Federica; Triventi, Michele; Calcagnini, Giovanni

doi:10.1002/mrm.25106

Cited by 50 publications

(46 citation statements)

References 23 publications

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“…A remnant nonfunctional lead is a contraindication for MRI due to the potential hazard for patients [29, 30]; this supports practicing routine extraction of retained lead materials in HTPL recipients. Although previous case series have suggested the safety of MRI in patients with retained leads [6, 9], experimental data have indicated the potential harm of MRI in patients with abandoned pacemaker leads [31, 32]. Nevertheless, there is a paucity of data on the hazards of MRI, particularly in cases with retained ICD/CRT-D lead materials.…”

Section: Discussionmentioning

confidence: 99%

Frequency and clinical impact of retained implantable cardioverter defibrillator lead materials in heart transplant recipients

et al. 2017

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End-stage heart failure patients with implantable cardioverter-defibrillator (ICD) with/without cardiac resynchronization therapy (CRT-D) often require heart transplantation (HTPL) as a last-resort treatment. We aimed to assess the frequency and clinical impact of retained ICD lead materials in HTPL patients. In this retrospective single center study, we examined the clinical records and chest radiographs of patients with ICD and CRT-D who underwent HTPL between January 1992 and July 2014. Of 40 patients with ICD and CRT-D at HTPL, 19 (47.5%) patients had retained ICD lead materials within the central venous system. Retained ICD lead materials following HTPL were more frequently noted in patients with longer implantation durations until HTPL. None of the patients underwent extraction procedures after HTPL. All patients were asymptomatic and did not exhibit significant complications or death related to the retained ICD lead materials. Seven (7/40, 17.5%) patients without any retained ICD lead materials underwent magnetic resonance imaging (MRI) during the follow-up period (median, 29.5 months); none of the patients with retained lead materials were given MRI. Considering the common use of MRI in HTPL patients, further studies on the prophylactic extraction of retained ICD lead materials and safety of MRI in these patients are needed.

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Section: Discussionmentioning

confidence: 99%

Frequency and clinical impact of retained implantable cardioverter defibrillator lead materials in heart transplant recipients

et al. 2017

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“…Lead heating of some degree is expected in the RF field related to induction of current in leads via Faraday's law and heat generation at the lead tip—myocardial interface secondary to disparate conductive resistance. Longer leads, abandoned leads, and looped leads appear to be particularly vulnerable to such heating . Heating in the MR scanner in human patients can be assessed indirectly through lead impedance and capture threshold (for which increases might suggest edema or thermal damage at the myocardial—lead tip interface) and sensing (for which decreases might suggest significant heating).…”

Section: Discussionmentioning

confidence: 99%

Clinical Performance of Magnetic Resonance Imaging Conditional and Nonconditional Cardiac Implantable Electronic Devices

Patel

Knežević

Hoskins

et al. 2017

Pacing Clinical Electrophis

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“…Thus, in a 3T scanner (

f

= 127.7 MHz), an implanted wire in the range of 12 cm in length should be especially worrisome, although, given variability in the electrical properties of different tissues and uncertainty in estimation of wavelengths, one should not assume there will be no heating based on the length of the wire alone. Other factors, such as how the wire is terminated, have also been shown to be important in this regard …”

Section: The Rf Fieldmentioning

confidence: 99%

The physics of MRI safety

Panych

Madore

2017

Magnetic Resonance Imaging

133

150

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The main risks associated with magnetic resonance imaging (MRI) have been extensively reported and studied; for example, everyday objects may turn into projectiles, energy deposition can cause burns, varying fields can induce nerve stimulation, and loud noises can lead to auditory loss. The present review article is geared toward providing intuition about the physical mechanisms that give rise to these risks. On the one hand, excellent literature already exists on the practical aspect of risk management, with clinical workflow and recommendations. On the other hand, excellent technical articles also exist that explain these risks from basic principles of electromagnetism. We felt that an underserved niche might be found between the two, ie, somewhere between basic science and practical advice, to help develop intuition about electromagnetism that might prove of practical value when working around MR scanners. Following a wide‐ranging introduction, risks originating from the main magnetic field, the excitation RF electromagnetic field, and switching of the imaging gradients will be presented in turn. Level of Evidence: 5 Technical Efficacy: 1 J. Magn. Reson. Imaging 2018;47:28–43.

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Impact of capped and uncapped abandoned leads on the heating of an MR‐conditional pacemaker implant

Cited by 50 publications

References 23 publications

Frequency and clinical impact of retained implantable cardioverter defibrillator lead materials in heart transplant recipients

Frequency and clinical impact of retained implantable cardioverter defibrillator lead materials in heart transplant recipients

Clinical Performance of Magnetic Resonance Imaging Conditional and Nonconditional Cardiac Implantable Electronic Devices

The physics of MRI safety

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