Emergent use of an MRI-conditional external pacemaker in a patient with sinus arrest facilitating diagnosis of a temporal lobe neoplasm

This report describes the case of a 66-year-old previously healthy man admitted to our institution for evaluation of new-onset syncope. The patient had witnessed seizures after admission associated with multiple periods of asystole on telemetry. A temporary pacemaker was emergently placed prior to transfer to the cardiac intensive care unit. An electroencephalogram (EEG) demonstrated a seizure focus at the right temporal lobe but a computed tomography (CT) scan of the brain was unrevealing; magnetic resonance imaging (MRI) was recommended. We describe the use of an active fixation right ventricular lead attached to an external MRI-conditional pacemaker generator prior to MRI scanning, which led to the diagnosis of anaplastic astrocytoma.