Abstract

BackgroundTemporary epicardial pacing wires, implemented in patients during heart transplantation, are routinely removed before discharge. However, in some cases, these wires may remain in situ and are often considered as a contraindication for cardiovascular magnetic resonance (CMR) imaging in the future. Therefore, we aimed to provide data about safety and image quality of CMR in these patients.Methods This is a report on a subpopulation out of 88 patients after heart transplantation that were included in a prospective cohort study and underwent multiple CMR in their post-transplant course. During CMR, patients were monitored by electrocardiogram and all examinations were observed by a physician to document potential adverse events. Additionally, image quality was assessed by an imaging specialist.ResultsNineteen of 88 patients included had temporary pacing wires in situ. These patients underwent a total of 51 CMR studies. No major adverse event and only one single, mild sensory event could be documented. All CMR studies showed preserved diagnostic image quality. Temporary pacing wires were visible in 100% of HASTE and cine sequences. In less than 50% of the examinations, temporary pacing wires were also visible in T1 and T2 mapping, short tau inversion recovery (STIR), and late gadolinium enhancement (LGE) sequences, without any impairment of image quality.ConclusionsWith a low event rate of only one mild adverse event during 51 CMR examinations (2%), CMR appears to be safe in patients with retained temporary epicardial pacing wires after heart transplantation. Moreover, image quality was not impaired by the presence of pacing wires.

Highlights

  • Patients after heart transplantation are at high risk for post-operative bradyarrhythmia, includingGatterer et al J Cardiovasc Magn Reson (2021) 23:24 cases, the wires have to be fixed at the myocardium or cannot be removed due to pericardial adhesion or overlap with sutures of the fascia

  • With these wires attached to the heart, patients are often excluded from magnetic resonance imaging (MRI) in the future [3]

  • Patient characteristics Overall, 88 patients were included in this ongoing prospective cohort study by July 2020

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Summary

Introduction

Gatterer et al J Cardiovasc Magn Reson (2021) 23:24 cases, the wires have to be fixed at the myocardium (e.g. fixation by a suture to stop bleeding at the time of the insertion) or cannot be removed due to pericardial adhesion or overlap with sutures of the fascia. In these cases, pacing wires are usually cut below the skin level. With these wires attached to the heart, patients are often excluded from magnetic resonance imaging (MRI) in the future [3]. We aimed to provide data about safety and image quality of CMR in these patients

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