Harvard Heart Letter

Heart Beat: Pacemakers and mammograms

Heart Beat

Pacemakers and mammograms

A word of caution to women with a pacemaker or implanted cardioverter/defibrillator (ICD): When you have a mammogram, make sure the technologist doing the scan knows that you have a device to regulate your heart. Without this important piece of information, the wire connecting the device to the heart (called the lead) could be damaged.

This happened to a patient of Dr. Mark M. Sherman, a cardiothoracic surgeon in Springfield, Mass. As the woman's breast was being compressed between the two plates of the mammography machine during an annual mammogram, she suddenly cried out in pain. The mammography technologist immediately stopped the procedure, waited until the pain was gone and the woman was all right, and then completed the scan. Three months later, during a routine follow-up visit for her pacemaker, Dr. Sherman found that the woman's device had stopped working the day of the mammogram. An x-ray showed a small break in the lead. He wrote about the case in a letter to the New England Journal of Medicine.

This certainly isn't a common occurrence. "I have never seen this happen, nor have any of my colleagues around the country with whom I've discussed this," says Dr. Daniel Kopans, the director of breast imaging and professor of radiology at Harvard-affiliated Massachusetts General Hospital. So it certainly shouldn't steer a woman away from having regular mammograms.

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