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Noncardiac Implantable Pacemakers and Stimulators: Current Role and Radiographic Appearance

¹ All authors: Department of Radiology, Winthrop-University Hospital, 259 First St., Mineola, NY 11501.

View larger version (126K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —72-year-old woman with Parkinson's disease managed with deep brain stimulator. Frontal chest radiograph shows bilateral deep brain stimulators (arrows).

View larger version (138K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —72-year-old woman with Parkinson's disease managed with deep brain stimulator. Scout lateral digital radiograph shows two leads (arrows) extending into brain.

View larger version (137K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —72-year-old woman with Parkinson's disease managed with deep brain stimulator. CT scan without contrast enhancement shows two leads (arrows) ending in region of globus pallidus.

View larger version (148K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —21-year-old woman with status epilepticus and mental retardation. Frontal chest radiograph shows stimulator with leads (arrow) overlying expected location of vagus nerve.

View larger version (99K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —21-year-old woman with status epilepticus and mental retardation. CT scan without IV contrast enhancement shows distal ends of leads (arrow) inside left carotid sheath.

View larger version (103K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —43-year-old woman with chronic low back pain, radiculopathy, and history of L5-S1 fusion. Frontal abdominal radiograph shows stimulator leads (arrow).

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —43-year-old woman with chronic low back pain, radiculopathy, and history of L5-S1 fusion. Frontal (B) and lateral (C) thoracic spinal radiographs show position of electrodes (arrows).

View larger version (115K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —43-year-old woman with chronic low back pain, radiculopathy, and history of L5-S1 fusion. Frontal (B) and lateral (C) thoracic spinal radiographs show position of electrodes (arrows).

View larger version (109K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4 —38-year-old woman with intractable lower back pain. Sagittal CT reformation of thoracic spine shows location of stimulator lead (arrow) composed of eight electrodes.

View larger version (141K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —39-year-old woman with urinary incontinence and bladder stimulator. Frontal (A) and lateral (B) spot radiographs obtained during surgery show placement of lead (arrow) for bladder stimulator.

View larger version (121K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —39-year-old woman with urinary incontinence and bladder stimulator. Frontal (A) and lateral (B) spot radiographs obtained during surgery show placement of lead (arrow) for bladder stimulator.

View larger version (100K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —39-year-old woman with urinary incontinence and bladder stimulator. CT scan of pelvis without contrast enhancement obtained to exclude abscess around stimulator shows course of lead (arrow) through right S3 neural foramen.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6A —61-year-old woman with gastroparesis and intractable abdominal pain. Frontal abdominal radiograph shows gastric pacemaker with two leads (arrows).

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6B —61-year-old woman with gastroparesis and intractable abdominal pain. CT scans (B at slightly higher level) show gastric pacemaker with leads (white arrow) abutting stomach wall (black arrow).

View larger version (143K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6C —61-year-old woman with gastroparesis and intractable abdominal pain. CT scans (B at slightly higher level) show gastric pacemaker with leads (white arrow) abutting stomach wall (black arrow).

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7A —17-year-old boy with chronic respiratory insufficiency after resection of tumor of cervical spine. Frontal radiograph of chest shows bilateral diaphragmatic receivers (black arrows) with leads (white arrows).

View larger version (124K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7B —17-year-old boy with chronic respiratory insufficiency after resection of tumor of cervical spine. CT scans show bilateral diaphragmatic pacer receivers (arrows).

View larger version (131K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7C —17-year-old boy with chronic respiratory insufficiency after resection of tumor of cervical spine. CT scans show bilateral diaphragmatic pacer receivers (arrows).

View larger version (131K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —10-year-old girl with respiratory insufficiency. Frontal radiograph of chest shows bilateral diaphragmatic stimulators (arrows). Cardiac pacemaker lead is looped in right atrium.

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —10-year-old girl with respiratory insufficiency. Close-up radiograph shows receiver.

View larger version (84K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —70-year-old man with Charcot foot. Anteroposterior (A) and lateral (B) radiographs of ankle show bone stimulator with generator (straight arrow) overlying distal tibia. Single lead (curved arrow) courses to region of lateral cuneiform bone. Relation of wire to screws is not entirely clear.

View larger version (57K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —70-year-old man with Charcot foot. Anteroposterior (A) and lateral (B) radiographs of ankle show bone stimulator with generator (straight arrow) overlying distal tibia. Single lead (curved arrow) courses to region of lateral cuneiform bone. Relation of wire to screws is not entirely clear.

View larger version (74K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9C —70-year-old man with Charcot foot. Oblique 3D CT reconstruction image shows position of lead (straight arrow) and lead tip (curved arrow) with respect to hardware and bony structures.

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