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Monday, April 26, 2021

Is it safe to do MRI in pacemaker patients with abandoned leads?

 Is it safe to perform an MR in a Pacemaker patient who has one or more abandoned leads? It seems that the conventional wisdom has been that it is not safe.

This article from RD Schaller et al (1) at the University of Pennsylvania  provides reassuring data. They present data on 139 patients in whom 200 MRs were performed without serious events. There were 5 instances of transient decrease in lead sensing and one patient complained of subjective sternal heating.

There no changes in battery voltage,or changes in pacing rate. Quoting the authors:

"The growing aggregate of data questions the absolute contraindication for MRI in patients with abandoned CIED leads." The authors also point out that CMS will not reimburse such cases.

(1) Schaller,RD et al, Magnetic resonance imaging in patients with cardiac implantable electronic devices with abandoned leads. JAMA Cardiol. published online Feb 17, 2021. doi:10/1001/jamacardiol.2020.7572

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