Abstract
Displacement of a cardiac pacemaker lead or myocardial perforation by a lead is an infrequent complication of pacemaker implantation. While standard cardiac CT is useful for diagnosing such complications when routine examinations can not, the potential risks associated with exposure to the high doses of radiation used in CT are of concern. Here, we report three cases in which pacemaker lead displacement or myocardial perforation was definitively diagnosed by low-dose cardiac CT used in the high-pitch spiral mode, when other more routine examinations failed to suggest their occurrence. The mean dose of radiation used for definitively diagnosing the three patients was relatively low (2.19 mSv).
Highlights
Several case reports have reported pacemaker lead displacement or perforation can be diagnosed by cardiac CT using the standard mode when the routine examinations are nondiagnostic [1] [2] [3]
While standard cardiac CT is useful for diagnosing such complications when routine examinations can not, the potential risks associated with exposure to the high doses of radiation used in CT are of concern
We diagnosed two leads displacement and one lead perforation of pacemaker according to the low-dose high-pitch cardiac CT and the mean effective radiation dose of these three cases was as low as 2.19 mSv
Summary
Several case reports have reported pacemaker lead displacement or perforation can be diagnosed by cardiac CT using the standard mode when the routine examinations are nondiagnostic [1] [2] [3]. The potential risks due to exposure to higher ionizing radiation associated with standard cardiac CT have raised concerns. The advent of second-generation, dual-source CT has led to the development of a prospective-ECG triggered high-pitch spiral mode for cardiac CT imaging; this mode has demonstrated high and stable image quality, high diagnostic accuracy, and significant dose reductions. We reported three abnormal pacemaker lead cases diagnosed by cardiac CT using this low-dose mode
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