Extended cardiac magnetic resonance imaging with retained temporary transmyocardial pacing lead

Excerpt

Temporary transmyocardial pacing leads, which are percutaneously placed into the myocardium of the right atrium and/or right ventricle and connected to an external pacemaker, are necessary to treat cardiac arrhythmias that can occur during the postoperative course after cardiac surgery [1]. During magnetic resonance imaging (MRI), retained pacing leads may act as antennas and absorb the electrical components of the radiofrequency fields, possibly leading to heating of the lead tip and subsequent myocardial injury. Although previous studies reported that MRI of non-cardiac regions can be performed with an acceptable benefit-risk ratio by following safety precautions and limitation of radiofrequency exposure (e.g. by using a transmit/receive coils), the presence of temporary transmyocardial pacing leads is still considered a relative contraindication to MRI [1]. During cardiac MRI, retained leads are directly positioned in the center of the radiofrequency field leading to an increased risk of radiofrequency-induced thermal injuries. Therefore, only insufficient data is available regarding cardiac MRI investigations with retained temporary pacing leads [2]. …