Pacemakers & MRI scans

[CDreamer]

As many of you contributed to a post a few weeks ago will know, concerns were expressed following a Chanel 4 Documentary on being denied MRI if you have a pacemaker. I wrote to one of the governors of our local hospital RD&E, Devon which I know several ?? Numbers ?? Members are also patients asking for their response to the documentary.?

This is the formal response I received which I found comprehensive & reassuring.

“We have an Standing Operating Procedure for scanning patients in MRI with MRI conditional pacemakers, defrbrillators and ICM’s (attached). The scan process is complex in order to meet the scanning restrictions specified by the manufacturers of these devices. The scan requires the presence of a Cardiologist, Cardiac Physiologist and Cardiac MR Radiographers. Bookings take an hour and require pre and post interrogation of the implanted device by the Cardiac Physiologist.

Not all pacemaker implanted systems meet the criteria for a MR conditional device.

We work closely with the MR responsible person and MR Cardiologist to manage referrals for MR for patients with implanted cardiac devices. In order to validate the request and ensure appropriate use of limited MR resources, we adhere to the following process:

· The request for an MRI scan for a patient with a MR Conditional Pacemaker or ICD must be justified by the MR Responsible person and Consultant Radiologist in conjunction with the MRI superintendent Radiographers to ensure that an MRI scan is the most appropriate examination and that the clinical information cannot be gained from an alternative imaging technique.

· If the scan request is justified Cardiology will be asked to provide evidence of the implanted device including make, model, implantation date and position and if the device is MR Conditional

·On receiving the above information the MRI team will check the device and any associated leads with the relevant manufacturer’s website to ensure all MRI scanning conditions can be met.

We currently aim to run one session which can accommodate 3 patients every other month, but each referral is individually reviewed and the frequency of lists is responsive to the number of cases waiting, their urgency and time from referral. Urgent cases can be organised on an adhoc basis.”

I hope that will also explain the complexity of the process & the co-operation between departments required.

Regards CD

[Coco51]

Thank you for sharing. Very informative.

[jedimasterlincoln]

That's very comprehensive!

[irene75359]

That is really interesting. Our friend here in Spain has been told he cannot have an MRI scan on his knee as he has a staple there from complex surgery due to rugby injuries more than thirty years ago. I investigated on his behalf (on the internet) and the general consensus is that it is safe. However, at the same time I read many conflicting reports about MRI scans on patients with pacemakers so it is good to know that your local hospital has a comprehensive procedure in place.

[seasider18]

When I had my private MRI scan at the Royal Sussex I expected the protocol you described to be followed but the pacemaker clinic technician just did an adjustment and told me go to the scanner unit and that was it. Went back after the scan and she reset it.

[Hidden]

Thank you, CD. I had no idea anyone had developed guidelines for us. I know yours are in the UK but I am going to check with my hospital and EP re what guidelines are in place for the hospital I always use in Atlanta (US).

It's also VERY helpful for me to know exactly what questions to ask should I find myself at a different facility in an emergency. I plan to print this and keep a copy in my wallet with my pacemaker card.

Thanks again. VERY TIMELY AND INFORMATIVE. Take care. irina

[CDreamer in reply to Hidden]

Hi Irina - our local hospital is run as a an NHS Trust which means it is financed by but not directly run by the NHS. There are a board of Governors who are elected by the ‘Members’ who are just anyone who uses the hospital and wants to be a member, that way you are able to gain certain entitlements.

I wrote to one of the Governors and got them to ask the question and indicated that there had been press interest and that was the response I received, there was some names mentioned which I obviously removed,

I think there is often a lack of communication by all staff to patients and I know this is the biggest concern of the Governors and one they are trying to change.

I can now see that there is a much more involved and complicated process than for someone without a PM but can you imagine if just one slip up by a staff member.

As an aside - my niece is a Radiographer and she married a technician who repairs these machines. I asked what was the most peculiar thing he ever had to deal with and he said a floor polisher that had been left in the room when the machine was then switched on - firmly stuck in the machine! I couldn’t get the image of a floor polisher suddenly flying across the room and it was anvery funny story but it also indicates the power of these machines and the care required to ensure safety.