Traditional chest X-ray and implanted cardio-systems

Authors: Shlyappo M.A., Safonova N.I., Aleksandrova S.A., Makarenko V.N., Temirbulatov I.A., Fridrikh O.A., Terekhov M.I., Zelikova L.V.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Clinical Cases


For citation: Shlyappo M.A., Safonova N.I., Aleksandrova S.A., Makarenko V.N., Temirbulatov I.A., Fridrikh O.A., Terekhov M.I., Zelikova L.V. Traditional chest X-ray and implanted cardio-systems. Creative Cardiology. 2022; 16 (1): 102–12 (in Russ.). DOI: 10.24022/1997-3187-2022-16-1-102-112

Received / Accepted:  20.11.2021 / 24.02.2022

Keywords: chest X-ray lead fracture pacemakers implantable cardioverter defibrillator active implanted cardiosystems MR-compatibility marks artifacts cardiac magnetic resonance imaging

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Chest X-ray remains a mandatory study during patients’ hospitalization, without losing its relevance. It allows to identify various lung diseases, changes in the pulmonary circulation, the presence of fluid and / or air in the pleural cavities, assess the position of the diaphragm, as well as the presence of additional shadows against the background of the heart, lungs and blood vessels. At the same time, modern X-ray installations and detectors have high resolution, which makes it possible to mark fine structures on the radiograph and monitor the condition of implanted electrodes and cardiac systems, without actually increasing the radiation load during the study. The number of patients with artificial pacemakers is increasing due to the improvement of cardiac stimulation systems and the expansion of indications for their implantation. At the same time, X-ray studies are the only way to identify metal defects, and therefore it is advisable to verify mechanical defects in implanted devices. These include technical factors due to the state of the electrode and its interaction with an active implanted cardiac device – a break or fracture of the electrode, disruption of contact between the stimulator and the electrode, dislocation of the electrode, dislocation of the devices and etc. The detection of a break/ fracture and the localization of such formidable complications is possible thanks to the classical chest X-ray. Traditional chest X-ray allows identification of the implanted device model, thanks to radiopaque markers. X-ray imaging of specialized marks helps not only when solving the issue of the possibility of conducting magnetic resonance imaging, but also when reprogramming the device by arrhythmologists.


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About Authors

  • Mariya A. Shlyappo, Cand. Med. Sci., Radiologist; ORCID
  • Nataliya I. Safonova, Cand. Med. Sci., Radiologist; ORCID
  • Svetlana A. Aleksandrova, Cand. Med. Sci., Senior Researcher, Head of Department; ORCID
  • Vladimir N. Makarenko, Dr. Med. Sci., Professor, Chief Researcher; ORCID
  • Ibragim A. Temirbulatov, Cardiovascular Surgeon; ORCID
  • Ol’ga A. Fridrikh, Radiologist; ORCID
  • Maksim I. Terekhov, Radiologist; ORCID
  • Larisa V. Zelikova, Radiologist, Head of Department; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery