Abstract
SummaryBackgroundLeadless pacemaker systems are an important upcoming device in clinical rhythmology. Currently two different products are available with the Micra system (Medtronic) being the most used in the clinical setting to date. The possibility to perform magnetic resonance imaging (MRI) is an important feature of modern pacemaker devices. Even though the Micra system is suitable for MRI, little is yet known about its impact on artifacts within the images.ObjectiveThe aim of our ex vivo study was to perform cardiac MRI to quantify the artifacts and to evaluate if artifacts limit or inhibit the assessment of the surrounding myocardium.MethodsAfter ex vivo implantation of the leadless pacemaker (LP) in a porcine model, hearts were filled with saline solution and fixed on wooden sticks on a plastic container. The model was examined at 1.5 T and at 3 T using conventional sequences and T2 mapping sequences. In addition, conventional X‑rays and computed tomography (CT) scans were performed.ResultsCorrect implantation of the LP could be performed in all hearts. In almost all MRI sequences the right ventricle and the septal region surrounding the (LP) were altered by an artifact and therefore would sustain limited assessment; however, the rest of the myocardium remained free of artifacts and evaluable for common radiologic diagnoses. A characteristic shamrock-shaped artifact was generated which appeared to be even more intense in magnitude and brightness when using 3 T compared to 1.5 T.ConclusionThe use of the Micra system in cardiac MRI appeared to be feasible. In our opinion, it will still be possible to make important clinical cardiac MRI diagnoses (the detection of major ischemic areas or inflammatory processes) in patients using the Micra system. We suggest the use of 1.5 T as the preferred method in clinical practice.
Highlights
The implantation of a permanent cardiac pacemaker device (PM) is currently the only effective treatment KVisualization and appearance of artifacts of leadless pacemaker systems in cardiac magnetic resonance imaging (MRI) 427option for symptomatic bradycardia, as evidenced by the reduction of symptoms, reduction of syncope and a decrease in overall mortality
In almost all MRI sequences the right ventricle and the septal region surrounding the (LP) were altered by an artifact and would sustain limited assessment; the rest of the myocardium remained free of artifacts and evaluable for common radiologic diagnoses
We present a general survey of possible MRI artifacts generated by the intracardiac leadless Micra System
Summary
The implantation of a permanent cardiac pacemaker device (PM) is currently the only effective treatment KVisualization and appearance of artifacts of leadless pacemaker systems in cardiac MRI 427option for symptomatic bradycardia, as evidenced by the reduction of symptoms, reduction of syncope and a decrease in overall mortality. The implantation of a permanent cardiac pacemaker device (PM) is currently the only effective treatment K. Typical systems consist of two components: the first is a pacemaker with integrated electronics and battery, usually implanted into a subcutaneous pocket of the pectoral region. The electrical impulse is generated within the pacemaker and is transmitted to the inner heart via one or more pacemaker leads which are usually implanted through the veins into the right ventricle. These devices have been shown to be safe and effective, a significant number of patients encounter complications during treatment. The surgical extraction of leads showing any kinds of functional loss or damage, are often challenging [1]
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