Leadless pacemakers can induce a metallic artifact that causes reduced septal uptake on single photon emission computed tomography.
Clinicians should be aware that leadless pacemakers can cause metallic artifacts mimicking reduced septal uptake on SPECT imaging.
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.
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.