Constantin Gatterer1,2, Marie-Elisabeth Stelzmüller3, Andreas Kammerlander2, Andreas Zuckermann3, Martin Krššák4,5, Christian Loewe1, Dietrich Beitzke6. 1. Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. 2. Department of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria. 3. Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. 4. Department of Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria. 5. Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, High-Field MR Centre, Vienna, Austria. 6. Department of Biomedical Imaging and Image-guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. dietrich.beitzke@meduniwien.ac.at.
Abstract
BACKGROUND: Temporary 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. RESULTS: Nineteen 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. CONCLUSIONS: With 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.
BACKGROUND: Temporary 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. RESULTS: Nineteen 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. CONCLUSIONS: With 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.
Entities:
Keywords:
Cardiac transplantation; Cardiovascular magnetic resonance; Image quality; MR safety