Cardiovascular Implantable Electronic Devices -> Bradycardia Devices: -> Device Technology D-PO02 - Poster Session II (ID 47) Poster

D-PO02-090 - Quantification Of Artifacts During Cardiac Magnetic Resonance In Patients With Leadless Micra Pacemakers (ID 200)


Background: When cardiac magnetic resonance (CMR) is performed after previous leadless transcatheter pacemaker implantation, an image distortion has to be expected in the heart region and evaluation of the myocardial tissue can be affected.
Objective: In this clinical prospective study, we aim to assess the extent and impact of this artifact on individual ventricular segments of CMR image.
Methods: Total of 20 patients with leadless pacemaker in the right ventricle underwent CMR imaging in a 1.5 Tesla scanner. A multiplanar segmentation was used to demarcate the left and right ventricular myocardium as well as the pacemaker-caused image artifact in systolic and diastolic time frames. Artifact size and its relative influence on myocardial segments were quantitatively assessed and expressed in AHA-17 model.
Results: Implanted leadless pacemaker caused an image artifact with a volume of 48 ± 5 mL. Most distorted were the apical septal (53 ± 23 %), apical inferior (30 ± 18 %), and midventricular inferoseptal (30 ± 20 %) segments. The artifact intersection with basal and lateral segments was none or negligible (up to 2%). The portion of LV myocardium affected by the artifact was significantly higher in systole (8 ± 4 %) compared to diastole (10 ± 3 %, P < 0.001).
Conclusion: Implantation of leadless pacemaker represents no obstacle for CMR imaging but causes an image artifact located mostly in septal, inferoseptal, and anteroseptal segments of apical and midventricular LV myocardium. With the exception of the apex, diastolic timing reduces the image distortion of all segments and improves global ventricular assessment.