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Chest X-Ray
 
 

Cardiac Devices on Chest X-Ray

February 15th, 2021
 
 
 
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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
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    A single chamber pacemaker PA film
     
  • A single chamber pacemaker: lateral film
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    A single chamber pacemaker lateral film
     
  • A multi-chamber pacemaker with old leads present: PA film
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    A multi-chamber pacemaker with old leads present PA film
     
  • A multi-chamber pacemaker with old leads present: lateral film
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    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
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    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.
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    Overlay
    A cardiac resynchronisation therapy (CRT) device without a defibrillator lead PA film.
     
  • A cardiac resynchronisation therapy (CRT) device without a defibrillator lead: lateral film
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    A cardiac resynchronisation therapy (CRT) device without a defibrillator lead lateral film
     
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