Pacer leads still in...Ouch!

[ElectLive]

Back to the leads, here is a very thorough AHA safety statement about MRI and all sorts of cardio devices and implants:

http://circ.ahajournals.org/content/116/24/2878.full

The type of lead matters, specifically temporary epicardial leads are deemed much safer than either temporary or permanent transvenous leads. The safety statement is very long, but here are a few quotes:

"Although the theoretical risk exists that MR examination in patients with retained temporary epicardial leads, which consist of electrically conductive material, could lead to cardiac excitation or thermal injury, such retained leads are typically relatively short in length, usually do not form large loops, and are generally not believed to pose a significant risk during MR scanning...Patients with retained temporary epicardial pacing wires are believed to be able to safely undergo MR procedures, and patients do not need to be routinely screened for the presence of such wires before scanning."

"Retained transvenous pacemaker and defibrillator leads (leads left in the body after explantation of the permanent pacemaker or ICD generator) pose significant theoretical risks, including heating and cardiac excitation. Retained fractured leads may pose a particularly high risk of thermal injury... MR examination of patients with retained transvenous leads is discouraged, and MR examination should only be considered in centers with expertise in MR and electrophysiology, and only in cases in which there is a strong clinical indication. MR examination should not be performed in patients with known retained transvenous leads that have fractures."

 

[Lynlw]

Back to the leads, here is a very thorough AHA safety statement about MRI and all sorts of cardio devices and implants:

http://circ.ahajournals.org/content/116/24/2878.full

The type of lead matters, specifically temporary epicardial leads are deemed much safer than either temporary or permanent transvenous leads. The safety statement is very long, but here are a few quotes:

"Although the theoretical risk exists that MR examination in patients with retained temporary epicardial leads, which consist of electrically conductive material, could lead to cardiac excitation or thermal injury, such retained leads are typically relatively short in length, usually do not form large loops, and are generally not believed to pose a significant risk during MR scanning...Patients with retained temporary epicardial pacing wires are believed to be able to safely undergo MR procedures, and patients do not need to be routinely screened for the presence of such wires before scanning."

"Retained transvenous pacemaker and defibrillator leads (leads left in the body after explantation of the permanent pacemaker or ICD generator) pose significant theoretical risks, including heating and cardiac excitation. Retained fractured leads may pose a particularly high risk of thermal injury... MR examination of patients with retained transvenous leads is discouraged, and MR examination should only be considered in centers with expertise in MR and electrophysiology, and only in cases in which there is a strong clinical indication. MR examination should not be performed in patients with known retained transvenous leads that have fractures."

Luckily for Justin, his pacemaker was epicardial placed, which can be a bigger deal when you have to have them implanted or replaced, since it is a bigger surgery placing the unit in your adbdomen /under ribs, but that probably helps as far as needing MRIs with the old leads still in.

One thing that seems pretty important to me, is IF you have anything in you that COULD cause concerns having MRIs, its probably a really good idea to have it done at hospitals, that have all kinds of resources, brains to pick and MRI Safety comittees to discuss and reasearch everything and decide not only if you can have it, the benefits and risk but probably even more importantly what settings are the "safest" for you but still give good pictures, and maybe not go to the small center tthey have that just do MRIs, Xrays etc.

For example , I know Hopkins has done MRIs on a few hundred pateints with pacemakers (not the MRI compatable) without any problems, of course they use certainsetting etc. so that is a good sign for people who just have old leads.

 

[watson524]

Scott - did they mention if there's anything to be done to relieve the soreness?

 

[scott.eitman]

Yes, pain management

Hows mom.

 

[watson524]

Hopefully the pain management works.

Mom's doing well, thanks for asking. She's on a New England/Canadian cruise right now. I think the cardio is doing an echo at her next visit in January'ish and then we'll plan a trip back to CCF for June'ish and continue with the CCF visits every year and local cardio every 6 months unless something changes that pattern.