How I Do It: Evaluating Cardiac Implantable Devices and Noncardiac Mimics on Chest Radiographs

Area of Science:

• Radiology
• Cardiology
• Medical Imaging

Background:

• Cardiac implantable electronic devices (CIEDs) are vital for managing cardiac conditions.
• The use of CIEDs, including pacemakers and defibrillators, is increasing.
• Radiographic assessment is crucial for device management and complication detection.

Purpose of the Study:

• To review the radiographic appearance, components, and placement of various CIEDs.
• To highlight imaging findings of common CIED complications.
• To differentiate CIEDs from non-cardiac mimics on radiographs.

Main Methods:

• Review of radiographic appearances of CIEDs and related devices.
• Discussion of typical components and anatomical placement.
• Analysis of imaging findings associated with complications like lead dislodgement and fracture.

Main Results:

• Detailed description of the radiographic characteristics of pacemakers, defibrillators, leadless pacemakers, and MRI-conditional devices.
• Identification of imaging signs of lead dislodgement, fracture, and perforation.
• Differentiation from non-cardiac mimics such as neurostimulators and markers.

Conclusions:

• Accurate radiographic identification of CIEDs and their positioning is essential.
• Imaging plays a key role in the early detection and management of CIED complications.
• Distinguishing CIEDs from mimics ensures appropriate patient care and intervention.