MRI safety in patients with abandoned temporary epicardial pacing wires: an eight-year retrospective study : Original...

To evaluate the prevalence and types of adverse events associated with magnetic resonance imaging (MRI) in patients with abandoned temporary epicardial pacing wires (TEPW) over an eight-year period. A total of 54 patients and 104 MRI examinations with abandoned TEPW (9 cardiac, 6 non-cardiac thoracic, 89 other) were included in the final analysis. Imaging was reviewed to confirm wire presence and billing information was queried to identify hardware manufacturer. The prevalence of major and minor adverse events as clinically documented or reported by the MRI safety team was recorded. Results were contextualized based on the duration that wires were in situ, when this information was available. No major adverse events were recorded. One minor sensory event occurred during a 1.5T cervical spine MRI in a patient with wires retained for 215 days. No acute abnormalities or wire positioning changes were noted. In situ duration ranged from 3 to 8684 days, with 4.8% of patients having wires for less than 1 month. Brain (36%) and abdominal (28.2%) MRIs were most frequent. No adverse events were reported in cardiac or thoracic MRIs. Most leads, including in the minor event, were Medtronic Bipolar Coaxial 6495. MRI in patients with abandoned TEPW has a very low rate of minor adverse events. No major events occurred over 8 years. MRI should not be withheld from patients with abandoned TEPW. Routine discussion of risks and benefits should continue with recognition that alternative tests may obviate the need for MRI. The low prevalence of minor adverse events is reassuring, and risks can be mitigated by ensuring compliance with manufacturer guidelines and minimizing energy deposition during imaging.