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.
Department of Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
J Cardiovasc Magn Reson. 2021 Mar 15;23(1):24. doi: 10.1186/s12968-021-00728-1.
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.
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.
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.
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.
在心脏移植过程中，临时的心外膜起搏导线会被植入患者体内，通常在出院前将其移除。然而，在某些情况下，这些导线可能会留在原位，并且通常被认为是未来进行心血管磁共振（CMR）成像的禁忌症。因此，我们旨在提供这些患者行 CMR 的安全性和图像质量的数据。
这是一项 88 例心脏移植患者的亚组报告，这些患者被纳入一项前瞻性队列研究，并在移植后接受了多次 CMR 检查。在 CMR 检查过程中，患者通过心电图进行监测，所有检查均由医生观察，以记录潜在的不良事件。此外，图像质量由影像学专家进行评估。
88 例患者中有 19 例患者存在临时起搏导线，共进行了 51 次 CMR 检查。仅记录到 1 例轻度感觉事件，无重大不良事件。所有 CMR 研究均显示保留了诊断图像质量。HASTE 和 cine 序列均能 100%显示临时起搏导线。在不到 50%的检查中，T1 和 T2 映射、短 tau 反转恢复（STIR）和晚期钆增强（LGE）序列也能显示临时起搏导线，但不会对图像质量造成任何影响。
在 51 次 CMR 检查中（2%）仅发生了 1 例轻度不良事件，这表明在心脏移植后存在临时心外膜起搏导线的患者中行 CMR 是安全的。此外，起搏导线的存在并未影响图像质量。
