title: Safety and outcomes of magnetic resonance imaging in patients with abandoned pacemaker and defibrillator leads.
abstract: BACKGROUND
  Abandoned cardiovascular implantable electronic device (CIED) leads remain a contraindication to magnetic resonance imaging (MRI) studies, largely due to in vitro data showing endocardial heating secondary to the radiofrequency field. We tested the hypothesis that abandoned CIED leads do not pose an increased risk of clinical harm for patients undergoing MRI.
  
  
  METHODS
  This single-center retrospective study examined the outcomes of patients who had device generators removed before MRI, rendering the device leads abandoned. Information was gathered through chart review. Data collected included lead model, pacing threshold before MRI, anatomic region examined, threshold data after generator reimplantation, and clinical patient outcome.
  
  
  RESULTS
  Patients (n = 19, 11 men and eight women) ranged in age from 19 to 85 at the time of MRI. There was a mean of 1.63 abandoned leads at the time of imaging; none of the leads were MRI conditional. Of the three implantable cardioverter defibrillator (ICD) leads, two of three were dual coil. Most (31/35) of the scans performed were of the central nervous system, including head and spinal imaging. There were no adverse events associated with MRI in any of these patients with abandoned leads within 7 days of the scan. No lead malfunctions or clinically significant change in pacing thresholds were noted with generator reimplantation.
  
  
  CONCLUSIONS
  The use of MRI in patients with abandoned cardiac device leads appears feasible when performed under careful monitoring, with no adverse events, although the experience is small. MRI did not affect the function of leads that were subsequently reconnected to a cardiac device.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: John V
authors.initials: JV
authors.lastname: Higgins
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gard
authors.forename: Seth H
authors.initials: SH
authors.lastname: Sheldon
authors.forename: Raul E
authors.initials: RE
authors.lastname: Espinosa
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Wood
authors.forename: Joel P
authors.initials: JP
authors.lastname: Felmlee
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.forename: Connie
authors.initials: C
authors.lastname: Dalzell
authors.forename: Nancy
authors.initials: N
authors.lastname: Acker
authors.forename: Robert E
authors.initials: RE
authors.lastname: Watson
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
mesh_terms: D000328:Adult; D000368:Aged; D000075202:Contraindications; D017147:Defibrillators, Implantable; D005260:Female; D005547:Foreign Bodies; D006321:Heart; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D055815:Young Adult
keywords: cardiac pacemaker; implantable cardioverter defibrillator; magnetic resonance imaging