PUB - Publikationen an der Universität Bielefeld

**Background and Aims**
Persistent reluctance to perform Magnetic Resonance Imaging (MRI) in patients with abandoned and/or epicardial leads of cardiac implantable electronic devices (CIEDs) 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**
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 (PRISMA) 2020 was used. International prospective register of systematic reviews (PROSPERO) registration number 465530.

**Results**
21 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 (MACE) was documented, although the possibility of underreporting 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.