We had a thread the other day about people with pacemakers being denied MRI scans - did anyone else see the feature on BBC news yesterday about this? And how there is too much misinformation on this subject and no-one should be denied having an MRI because they have a pacemaker.
I’ll see if I can find a link.
I know that modern PMs are MRI compatible in most cases but some earlier ones with metal cases are not. One is always asked if one has any metal inside us before such scan as there is a danger of it being dragged out apparently. As an engineer with possible bits of steel inside me I had to have Xrays first to check!
The problem seems to be that some hospitals are refusing MRIs to patients because of protocols which are outdated. The fact it was covered on national news indicates it is a problem not because of the technology but from job’s worth inaccurate protocols.
This is not exactly on the same tac CDreamer but there is also continuing concern re. older people being denied expensive tests AND even cataract lens replace! We do have to keep vigilant.
I know there was a monitorium g on cataract lens replacement unless you were considered blind but that was because of money. This seems to be misinformation. I have just emailed one of our local hospital governors with the Channel 4 news link asking for clarification on their position. I’ll let you know the outcome.
Interesting, I have been diagnosed with cataracts in both eyes recently and had an appointment with a specialist who confirmed this but who said that as I had a history of Herpes D in the right eye, the last episode being late last year, they would rather not operate if I could manage as I do by keep changing glasses all day long, apparently operating carries risk of the virus returning and seating deep in the eye socket and worse case scenario, I could loose the eye!!!!!! You know my answer, keep going with the glasses lol. Having read your post it has left me wondering........
Could there also be an issue about the materials used in different MRI equipment-some being older than others? I would feel more secure if there were more transparancy as to why some hospital allow and some don't. One non-transparancy that comes to mind is that a particular hospital may have had a past problem- maybe involving a lawsuit and would rather be conservative. Just a thought. Take care. irina
Good point - and I wish it were that easy but the journalist implied it was lack of good information rather than good equipment. Interesting that AFA were asking for people to come forward if they had been denied a MRI last week because a journalist had approached them but this originally came up in a thread I posted about just having a pacemaker inserted and Seasider reported being refused by hospitals in the SE particularly. It seemed as though they were protecting themselves from possible litigation as there was a mix of NHS and private company who couldn’t agree protocols for MRI for people with pacemakers.
Our local hospital where the MRI scanner is run by the private InHealth Group has at last agreed a protocol with cardiology to scan patients with MRI compatible pacemakers.
I imagine this will probably apply to all 30+ InHealth facilities.
Well thank goodness for that! I checked with our hospital trust and they do have a protocol but it is quite complicated.
I read the one on my pacemakers web site but the procedure when I had a scan done privately at the Royal Sussex in 2016 was nothing like it.
Will see what this one does when I have it.
When I go for mine I have an E-Mail from the PA of the consultant who fitted my Amplatzer amulet " This has come up many a time and Professor Hildick-Smith’s reply to the various MRI departments is that “all closure devices are made of nitinol and are non-ferromagnetic and are fine for MRI scanning”.
Thanks for that info CD - sounds like some people will have a battle on their hands if they need a MRI - it really is very bad that many hospitals refuse scans on those grounds. I think R D & E Exeter is okay, if I remember rightly my Dad who had a pacemaker had a MRI scan just a few years ago there.
Cassie
It's a confusing issue and I have not yet seen information that eases my mind.I received a single lead pacemaker made by Boston Scientific (US) in November 2016 set at a rate of 70. It continues to work fine. I was told at the time NOT to have any MRI's. Since then I had heard that some pacemakers may be MRI-compatible and have also received conflicting information during emergency room visits that MRI's were ok with other staff warning against them. It may have to do with the model type. I am a retired nurse and for me I will not have an MRI. Better safe than sorry and if a doctor has a cavalier attitude telling me it's "probably"alright. My answer to them is is to ask them if they weren't sure would they want a family member to have an MRI. My answer is NO until all the evidence is in and everyone is on the same page about this issue. I'm afraid to take a chance. Just my personal feeling about my care. irina
I have a 3 lead Medtronic which the company verifies as MRI compatible. Most pacemakers inserted after 2014-15 seem to be OK to go through the machine and your pacemaker card will indicate whether both the pacemaker itself and the leads are or not compatible but in any case, older versions can be adjusted to not be affected with the correct protocols in place,
At a conference in London run by Sabine Ernst at Brompton Hospital about ten years ago a specialist stated that metal cased PMs were not compatible with MRI scans but that the new models coming through were non magnetic and should be OK . Yes this was ten years ago so I would have thought that the problem should have washed out my now.
Hi CDreamer, (and BobD) I am so glad you started this thread. I have been wrong all along about my own pacemaker not being MRI compatible. I checked my wallet card and it gave no clue about the MRI issue so this morning I called the head pacemaker technologist at my Electrophysiologists office and she called back this afternoon and was a mine of info. I don't know where my mind was in 2016 when I heard my pacer was not compatible (maybe doped up!). Finding out mine is compatible is a real weight off my mind. MRI's can be a great diagnostic tool. Mine IS made of titanium. She told me the complete name of my model is an "L310Accolade MRI" Makes me wonder how many people don' t have accurate info about Boston Scientific medical devices. This info should be on our cards and documents. It does say they are made of titanium but how many patients just think of this substance as a garden-variety metal and don't understand how its properties are different from the old metals used years ago? Thanks for starting the topic and I stand corrected. Take care. irina
You are welcome. I think it is easy to mis-hear, misunderstand etc and or forget!
I agree, I don’t think we ask enough questions or check out what exactly is being put inside us or the consequence. This particular issue though seems to miscommunication within the hospitals and misinformed staff and a lack of having appropriate protocols for those with pacemakers which seems counter-productive.
I agree. And I also think staff information should be filtered down to the rank and file like x-ray technicians. They are not always deemed important by the powers that be but they are the final contact a patient has before a chance to prevent potential problems is gone. Here (US) I have always had competent technicians performing xrays and other non-invasive tests but while they know how to correctly perform their job they very often, in my opinion, don't know why protocols are in place. My experience throughout life is that when people understand why they are doing things a certain way they are much more compliant. Otherwise their own judgment comes into play and they may not have the information that could prevent a problem.
Regarding my hearing my pacemaker info incorrectly, as I recall, the pacemaker box (containing literature, wallet card, wireless remote, etc) was brought to me in the recovery room and also where explanations about the pacer were given. Probably not the best time as I'm sure I wasn't alert enough to correctly process some of the info.
Thanks again,CD. irina
When I had my pacemaker fitted I was told it was Titanium and MRI proof but with a prior adjustment before having an MRI so I really don't know, and no I didn't see the programme mores the pity.
just a thought. But I wonder if replace. hips are mostly now titanium because it allows for an MRI later if nec. or am I in cloud cuckoo land/wishful thing land?
Titanium is used for implants because it is very light and as the body doesn’t react to it so bone for instance will adhere and grow around it.
I think the MRI bit is just a side benefit.
No you're not in cloud cuckoo land. When I had my brain tumour surgery I was a bit worried about future MRIs and was told that the plates/bolts/screws etc inside were made of titanium and were all OK with MRIs. Other metals are not. However when I went through a scanner at the airport they did stop and re-do the checks on my head and also my stomach (which has a "plastic" hipper hoop inside.
Interesting viewing. In fact quite frightening when you see the consequences of being denied a MRI.
Hi All, I have a MR compatible pacemaker and was refused an MR. The reason stated was that the imaging centre needed special equipment before scanning. I checked out the user manual of my pacemaker (available online!) and it clearly states that the pacemaker must be switched to MR Safe mode before scanning. To switch to this mode, the centre needs a device from the pacemaker manufacturer to interface with it. Many/most centres do not have this equipment or they do not feel confident interfacing with a pacemaker. So the easiest approach is to refuse the scan. Also worth noting that the equipment is different for each manufacturer (Medtronic, Boston, St Jude, etc). My experience was in France, where you have free choice of imaging centres, so you can shop around and find one with the right equipment and protocols. In the UK it is much more difficult through the NHS, but I'm sure if one insists, the imaging department will confirm whether they can scan your pacemaker if you supply them full details of make and model beforehand.
The pacemaker clinic at the hospital that fitted my device say that they can now reset any make of MRI compatible pacemaker but the private company In Health who run the imaging unit there and at about 40 other hospitals refuse to scan patients with them. I last checked about a month ago after my EP referred me for an MRI scan that they had refused to do in June..
Perhaps it would be a good idea to take this up with the AFA. Are you going to Patient’s Day?
Does anyone know why the private Health company has taken that stance? Or challenged their thinking and decision?
They told me that they are not NHS so cannot take chances with patients !
Obviously cardiology and them have been at loggerheads over this for over three years. Cardiology are happy with the laid down protocol from the makers and it several times has been almost concluded.
I want/need a standing MRI in an open scanner when I have weight on my spine. None of the few open scanner sites will do it. The Boston Scientific rep will come along to reset it but she needs a physiologist or a doctor present as back up and we have been unable to arrange that despite my EP asking nearby Barts if they could help out.
When I had an MRI at the Royal Sussex they just reset it and sent me down to the imaging centre without that back up although it is detailed in the protocol.
What a #@%^up. Implant life-saving devices and then limit their use. Like buying an expensive smartphone and finding out the accompanying directions don't provide complete info in how to use the bells and whistles. So half the phone goes unused. This happened to me. When I buy something technological I need all the help I can get. And this includes clear, concise, complete directions.
Many if not most of the imaging centres are run by private companies as the NHS cannot afford to buy the scanners.
Interesting additional information. The more we know the less side effects and more benefits we have. It would make sense to have the scanner in the same place as the xray machine. So simple. You have a pacemaker, you get the scanner! Maybe too simple a concept, or more likely, an added expense to update equipment. Sorry to be so cynical.
They are in the same hospitals. In Health presumably rent or are given space by the hospital. They scan private patients and get paid by the NHS for scans on NHS patients. At busy times they also have a mobile scanner truck in the car park.
The local private hospital also has an MRI scanner but no longer have a physiologist to call on.
There is another mobile scanner at the MSK clinic from time to time. MSK is a privatised service with a five year contract to cover muscular skeletal and arthritis instead of the NHS.
Last few times I had MRI - last September after TIA - the scanner was in a trailer, in the car park.
They are noisy s you walk bye 
Just off topic a little. Are MRI's expensive? As I had to push tooth and nail to get one on my heart. I eventually had to go to my local mp to get things sorted as the local hospital trust wouldn't pay as I had been referred to another hospital out of catchment. They offered me this as wait times were less??? All NHS not private. I waited 6 months while they argued about it!
Yes they are expensive - dependent upon who you talk to each one can cost up to £2k if you factor in overheads and staffing costs so they are not ordered freely.
Of course all NHS is not private but you would be very surprised at what is and is not privately provided through tendering out to private companies because most of the time it is seamless and you wouldn’t know.
90% of our GP services are private practices for instance yet few seem to know or recognize this and believe it is all NHS. There are privately funded specialist nurses - often sponsored by charities - in most hospitals in the country - could you tell who is paid by whom? I can’t. I know of several privately funded nurses sponsored by drug companies. Many services are tendered out - including MRI services.
In my area CT scanners are funded by Friends of the Hospital. They are on their way to the next half million for another one.
Trouble is that some things they pay for are underused due to doctor shortages, When I was referred for a Friends funded stress echocardiogram it was a 17 week wait as they were only doing four a week as a doctor had to be present during it. After I complained they upped it to ten a week or twenty hours of doctors time a week that is still under use of the equipment.
I had mine on a Monday but by the Friday the cardiologist had not been given the report from it. He searched for her in vain and eventually accepted what I told him from the questions I had asked during the procedure.
My present Medtronic pacemaker is MRI safe, but the leads are not as they are the original leads from about 20 years ago! I'm due a fourth pacemaker shortly, but it is apparently risky to replace leads with modern MRI safe versions, as they will be well bedded-in to the heart muscle and need to be removed. The danger is overheating of the leads during the scan, so not sure where I stand should I need one.
I hope you never need one, very much Hobson’s choice.
I live in Australia and have an Biotronik Evia DR-T Pacemaker inserted in 2015. It is approved by TGA only for 1.5T MRI. Not 3T as in Germany France Italy and others
The TGA is very behind the times here unfortunately
I have had a brain tumour and need regular MRIs and I have been told by the hospital that an MRI scanner can mess up a pacemaker. Therefore a conundrum pacemaker -v- MRI priority.
Regarding tendering out in the NHS - last year my GP arranged for me to have an Echocardigram last August at my local hospital prior to me seeing a EP at Papworth privately so he would have an up to date info. After the scan I asked the guy who did it for a copy, his reply that this would only be sent to the person who ordered it - they were a private company operating the echos for the NHS. I did get a copy from my surgery, gave this to the EP when I saw him and he declared in effect it was rubbish. It gave him little detail so I had to have another one at Papworth. The scan at local hospital took 20 mins - I thought it was a bit quick at the time - the scan at Papworth took nearly an hour!!!!!!!!! She scanned all areas of the heart, even the neck veins. This second scan was not done privately as EP had put me on his NHS list. I leave you to your conclusions.
When EP looked at scan he remarked that he knew the name of the operator and said I know this guy - I wondered what had happened to him - he used to work at Papworth!
Cassie
It seems more and more of the info we receive as patients (read customers) is just the tip of the information iceberg. I now have many more questions to ask at my next pacemaker check visit.
Bob is quite right as usual. I had brain tumour surgery and therefore MRIs were an important part of my treatment. However when I started my Afib problems and suggestions were made as to a pacemaker, I was told that having a pacemaker especially the technical stuff inside or if it had any little bits of metal in it were a no-go as far as an MRI is concerned. This was from St Georges in Tooting which is a very good hospital.
And times & technologies & protocols have changed. I checked with our local hospital & there are specific protocols but there should be no difficulties for modern PM’s other than the political ones. My pacemaker is labelled MRI safe but I have to say I don’t go through the airport scanners!
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