Key result
Leadless pacemakers can induce metallic artifacts that reduce septal uptake on SPECT.
Clinicians should be aware that leadless pacemakers can cause metallic artifacts mimicking reduced septal uptake on SPECT imaging.
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Potential metallic artifacts from leadless pacemakers may obscure septal uptake on imaging; leaves open need for validation in larger cohorts.
An 82-year-old man was admitted to our hospital for pneumonia complicated by worsening heart failure. He had a history of permanent atrial fibrillation with complete atrioventricular block and had undergone leadless pacemakers (LPM) implantation two years earlier (Figure 1A). Coronary angiography performed prior to LPM implantation revealed no significant stenosis.
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Arigami et al. (2026) studied this question. Leadless pacemakers can induce a metallic artifact that causes reduced septal uptake on single photon emission computed tomography.
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