Electrocardiographic modifications induced by breast implants

Abstract

Background Echocardiography realization can be challenging in the presence of breasts implants (BI). It is less known if electrocardiograms (ECG) may be modified in the presence of BI. Methods ECG from women with BI (and without any known cardiac structural disease) were sent and analyzed by two experienced electrophysiologists (EP1 and EP2) who were blinded and completely unaware of the context of the patients (Group 1). ECG from a control matched‐group of female women without BI (Group 2) were also blindly sent for analysis. Results ECG were collected from 28 women with BI (42 ± 8 years) without any acute medical condition. A proportion of 42% of the ECG were considered abnormal by EP1 and 46% by EP2. The abnormalities were for EP1: negative T waves (5), ST depression in inferolateral leads (2), absence of R wave progression from V1 to V4 (4), left ventricular (LV) hypertrophy (1), long QT(1), early repolarization (1), short PR (1); For EP2: negative T waves (6), ST depression in inferolateral leads (2), absence of R wave progression from V1 to V4 (4), LV hypertrophy(3), long QT (1), early repolarization (1). ECG from group 2 were considered abnormal in only 1 patient (5%) for EP1, and normal in all for EP2 (P = 0.0002 between the groups). Conclusions ECG from women with BI were considered abnormal in 42% to 46% of the cases by expert readers. ECG interpretation can thus be misleading in these women.

Breast Implants in A Woman Associated With Low-Voltage Electrocardiogram (ECG)

“…Since the vast majority of participants did not have preoperative ECG, the abnormalities on the ECGs could not be attributed to the BIs for certain. However, the prevalence of ECG abnormalities reported in this study was significantly higher than a study including a large population of non-athlete young female subjects, in which mainly QT abnormalities were detected [2,3]. Although the absence of R wave progression from V1 to V4 was reported in some individuals in the previous study, there is no report regarding low QRS voltage in both precordial and limb derivations in a woman with BIs.…”

“…The low-voltage Electrocardiogram (ECG) can be associated with either the problems of voltage generated by the heart or other non-cardiac conditions such as the problems of voltage transmission and electrode placement and equipment issues [1]. In recent years, Breast Implants (BIs) in women have been shown to cause ECG modifications [2]. However, the impacts of BIs on ECG modification have not been studied thoroughly in a large-scale prospective study.…”

Managing patients with sex-, race-, or ethnicity-based cardiovascular health inequities

“…Research also has shown evidence of further inaccuracy in ECG interpretation in patients after breast augmentation with implanted silicone breast prostheses compared with unaugmented breast tissue. In a blinded study, experienced electrophysiologists analyzed the ECGs of participants with and without silicone breast implants 28. Of participants with breast implants, 42% to 46% were inaccurately interpreted as abnormal 28.…”

No Diagnostic Concerns With Cardiovascular Magnetic Resonance Imaging in Patients With Breast Cancer and Breast Implants

“…Alternative imaging modalities are therefore commonly required to ensure accurate diagnosis and appropriate clinical decision-making. Investigation and monitoring of incident CV toxic effects also requires optimal CV noninvasive imaging, and the spectrum of disease demands a multimodality approach, with false-positive results reported in this patient group with both electrocardiography and nuclear (single-photon emission computed tomography) imaging …”