Cardiac Devices on Chest X-Ray
February 15th, 2021
On this page:PacemakerAutomatic Implantable Cardioverter DefibrillatorCardiac Resynchronisation Therapy (CRT)
Overview
The chest x-ray is a useful tool for determining the type of cardiac device present.
Both PA and lateral films should be used to identify the location of leads associated with a cardiac device.
Pacemaker
A pacemaker is a device that provides an electrical impulse to the myocardium to stimulate contraction in response to bradyarrhythmia.
Types of Pacemaker
- Single chamber pacemaker - a single lead within the right atrium or right ventricle
- Dual chamber pacemaker - leads within the right atrium and right ventricle
- Biventricular pacemaker - also known as a cardia resynchronisation therapy (CRT) device (see below)
Examples
- A single chamber pacemaker: PA film
![A single chamber pacemaker PA film]()
- A single chamber pacemaker: lateral film
![A single chamber pacemaker lateral film]()
- A multi-chamber pacemaker with old leads present: PA film
![A multi-chamber pacemaker with old leads present PA film]()
- A multi-chamber pacemaker with old leads present: lateral film
![A multi-chamber pacemaker with old leads present lateral film]()
Automatic Implantable Cardioverter Defibrillator
An automatic implantable cardioverter-defibrillator (AICD) is capable of delivering a large amount of energy to cardiovert or defibrillate a patient out of a life-threatening tachyarrhythmia.
Look For
- A single lead with one or two large coils.
An AICD may be combined with a pacemaker in patients with multiple indications.
Example
- An AICD with two large coils present
![An AICD with two large coils present]()
Cardiac Resynchronisation Therapy (CRT)
Leads within the left and right ventricles, used to coordinate contraction of the ventricles in patients with severe heart failure.
A cardiac resynchronisation therapy device may also be combined with a defibrillation lead (CRT-D).
Example
- A cardiac resynchronisation therapy (CRT) device without a defibrillator lead: PA film.
![A cardiac resynchronisation therapy (CRT) device without a defibrillator lead PA film.]()
- A cardiac resynchronisation therapy (CRT) device without a defibrillator lead: lateral film
![A cardiac resynchronisation therapy (CRT) device without a defibrillator lead lateral film]()
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