For millions of people living with a heart condition, having a pacemaker fitted can be a vital and even life-saving step – but what happens if you need to have an MRI scan?
It’s not uncommon for people to be told they can’t have an MRI scan if they have a pacemaker or implanted cardiac device, and worry that the procedure would be unsafe. However, contrary to common belief, this is no longer the case.
The Chenies Mews Imaging Centre (one of Queen Square Private Healthcare’s specialist diagnostic facilities in central London) is one of a small number of clinics that currently routinely offers MRI services for patients with pacemakers. The procedure is safe, but there are a number of important considerations that apply. Here, Dr Charlotte Manisty, Consultant Cardiologist at London’s Barts Heart Centre and a specialist in cardiac imaging, explains more.
Why the confusion over MRI scans and pacemakers?
Pacemakers have been around since the 1960s, but since then, the technology and safety testing around them has come a long way. There was a time when having a pacemaker or implanted cardiac device was deemed a problem if a patient needed an MRI. The worry was that the magnetic and radiofrequency fields used during the scan would interfere with the function of the pacemaker, posing a risk to the patient. But, generally speaking, this is no longer the case, provided safety protocols are followed.
Pacemaker technology has advanced
“Historically, patients with pacemakers have been told they can’t have MRI scans, but there have been two main changes within the last 10 years or so,” explains Dr Manisty. “Firstly, manufacturers have started designing and testing devices to be safe within the MRI environment. So now, nearly all devices that are implanted in the UK at the current time are ‘MRI conditional’, so providing fairly basic safety protocols are followed, they can be scanned safely.”
What are the safety protocols?
The additional safety steps are actually relatively straightforward.
“The key thing we need when a patient is referred is their device details – the manufacturer and model of their leads and box,” says Manisty. This will enable the clinic to check whether the device is ‘MRI-conditional’ and whether there are any specific requirements to be used for that particular device. After that, the patient just needs to come for the scan, and we will check their device function beforehand and re-programme it into ‘MRI mode’ for the study.
“For patients with MRI conditional devices, there’s literally just a simple programming change that needs to be activated so they are in MRI-safe mode, and then they are scanned. We monitor them during the scan, and immediately following the scan we put the device back to the original settings. That’s a very straightforward procedure but it does require a cardiac physiologist to be present to be able to do that.”
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What about older implanted devices?
The second key change in terms of pacemakers and MRI scans, adds Manisty, is the increase in MRI safety tests for older devices. This has meant a growing body of evidence that “even older legacy devices, which have not been strictly designed to go into an MRI scanner, can be scanned without complication – but slightly more stringent protocols need to be followed with these patients and only certain places will scan these patients”. In these cases, patients will need to have their scan at Barts Heart Centre – however, the team at Chenies Mews can take care of coordinating the arrangements for patients.
Dr Manisty explains that with non-MRI conditional devices, it’s more a question of manually reprogramming the device settings to make them MRI-safe, and then resetting them – rather than being able to do this with one simple switch. This will be performed by a specialist and patients will be monitored closely throughout. There are now very few occasions where a person won’t be able to have an MRI scan at all.
If you would like to discuss an MRI appointment at the Chenies Mews Imaging Centre, get in touch with the team on 020 3887 0566. Alternatively you can make an enquiry online.