Low-Dose High-Pitch Cardiac CT to Evaluate Abnormal Pacemaker Lead Position

Displacement of a cardiac pacemaker lead or myocardial perforation by a lead is an infrequent complication of pacemaker implantation. While standard cardiac CT is useful for diagnosing such complications when routine examinations can not, the potential risks associated with exposure to the high doses of radiation used in CT are of concern. Here, we report three cases in which pacemaker lead displacement or myocardial perforation was definitively diagnosed by low-dose cardiac CT used in the high-pitch spiral mode, when other more routine examinations failed to suggest their occurrence. The mean dose of radiation used for definitively diagnosing the three patients was relatively low (2.19 mSv).