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Meta-Analysis
. 2024 Jun 3;26(6):euae165.
doi: 10.1093/europace/euae165.

Safety of magnetic resonance imaging in patients with cardiac implantable electronic devices and abandoned or epicardial leads: a systematic review and meta-analysis

Claudia Meier  1   2 , Carsten Israel  3 , Michel Eisenblätter  2   4 , Annika Hoyer  2   5 , Ferdinand Valentin Stoye  2   5 , Ali Yilmaz  6 , Stephan Gielen  1   2
Affiliations
Meta-Analysis

Safety of magnetic resonance imaging in patients with cardiac implantable electronic devices and abandoned or epicardial leads: a systematic review and meta-analysis

Claudia Meier et al. Europace. .

Abstract

Aims: Persistent reluctance to perform magnetic resonance imaging (MRI) in patients with abandoned and/or epicardial leads of cardiac implantable electronic devices is related to in vitro studies reporting tip heating. While there is a plethora of data on the safety of MRI in conditional and non-conditional implantable devices, there is a clear lack of safety data in patients with abandoned and/or epicardial leads.

Methods and results: Relevant literature was identified in Medline and CINAHL using the key terms 'magnetic resonance imaging' AND 'abandoned leads' OR 'epicardial leads'. Secondary literature and cross-references were supplemented. For reporting guidance, the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 was used. International Prospective Register of Systematic Reviews (PROSPERO) registration number 465530. Twenty-one publications with a total of 656 patients with 854 abandoned and/or epicardial leads and 929 MRI scans of different anatomical regions were included. No scan-related major adverse cardiac event was documented, although the possibility of under-reporting of critical events in the literature should be considered. Furthermore, no severe device dysfunction or severe arrhythmia was reported. Mainly transient lead parameter changes were observed in 2.8% in the subgroup of patients with functional epicardial leads. As a possible correlate of myocardial affection, subjective sensations occurred mainly in the subgroup with abandoned epicardial leads (4.0%), but no change in myocardial biomarkers was observed.

Conclusion: Existing publications did not report any relevant adverse events for MRI in patients with abandoned and/or epicardial leads if performed according to strict safety guidelines. However, a more rigorous risk-benefit calculation should be made for patients with epicardial leads.

Keywords: Abandoned leads; Cardiac implantable electronic devices (CIEDs); Epicardial electrodes; Magnetic resonance imaging (MRI); Safety; Tip heating.

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Conflict of interest statement

Conflict of interest: C.I.: advisory board: Impulse Dynamics and Medtronic Inc.; sponsored research: Medtronic and MicroPort; honoraria: Abbott, Biotronik, Boston Scientific, Impulse Dynamics, Medtronic, Microport, and Zoll; travel/congress cost reimbursement: Abbott, Biotronik, Boston Scientific, Impulse Dynamics, Medtronic, Microport, and Zoll. All remaining authors have declared no conflicts of interest.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
PRISMA flow chart.
Figure 2
Figure 2
Anatomic region scanned.
Figure 3
Figure 3
Forest plot beta-binominal model of the outcome ‘sensations’. CI, confidence interval.
See this image and copyright information in PMC

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