Abstract 9607: CIED and Non-CIED MRI Imaging; Should Capped or Uncapped Abandoned Leads Remain a Contraindication?

Abstract

Introduction: Infrequently, MRI is performed on patients with conventional pacemakers or ICDs. While multiple studies have documented the safety of MRI scans when performed with an approved protocol, retained leads (capped or uncapped) remain a significant concern. Hypothesis: We hypothesize that non-CIED and CIED devices in the presence of capped and uncapped leads, while inherently having no ability to for interrogation, can be performed under a similar MRI-device protocol in a safe and reliable fashion. Methods: Adapting the same MRI-device protocol as for either CIED or non-CIEDs as appropriate, tracking of patient safety to include chest pain, sustained arrhythmias or change in any device setting was performed. Results: A total of 311 pts with CIED (81%) and non-CIED (19%) from 2019-2021 at Allegheny General Hospital incorporating a total of 16 (5%) pts with retained/abandoned/fragmented leads (56% capped and 44% uncapped; p=NS) as well as 3 epicardial leads underwent MRI (GE; EXCITE, 1.5T; WI) of several regions (Brain; 72%, Ortho; 17% and CV; 11%). Repeat imaging was common (12%). Utilizing an established device protocol according to CIED or non-CIED, pts were programmed based on pt-specific pacing requirements. There were no episodes of abnormal vital signs, chest pain, sustained arrhythmias or any clinically significant device setting changes. No significant changes to impedance, amplitude, voltage or sensitivity to RA or RV/LV parameters occurred. There were no differences, naturally, between capped, uncapped or epicardial lead metrics. Likewise, no power-on resets or pacing changes were noted in the primary device system. Altogether, this supports the absence of myocardial or extra-cardiac thermal-induced injury. Infrequent, clinically insignificantly decreased RA sensing, a common natural observation in contemporary interrogation, was infrequently and transiently noted. Conclusions: Following a standard MRI protocol, according to CIED and non-CIED in pts with either capped or uncapped abandoned leads, pts suffered no ill consequences when tracked for CP, arrhythmias or device setting changes supporting a proof-of-concept notion for removing yet another obstacle for often life-changing MRI in patients with PM/ICDs.