MRI

Sorta Right

by BillH - 2016-10-22 00:33:16

The GP is sorta right.

There was a registry that kept track of doing MRI test on non MRI approved PM's. Since many new devices have been certified it has not been continued.

However, many cardiologist & EP think that it can be safetly done with proper care and planning. But it is hard to find people that will do it.

This is for "modern" PM's. I don't remember the exact date, but I think the last 10-15 years.

MRI Compatible

by Captain Ratedrop - 2016-10-22 03:03:55

Hello Forum...I'm new and my first post.  I'm a long time cardiac patient and thank the site.  From what I've found.....

Not all pacemakers (and not talking ICD's) are created alike.  While theoretically some older paceakers may be ok--look up Dr. Saman Nazarian at Johns Hopkins that helped to develop the protocol for MRI testing for patients with MRIs.  However hospitals will very reluctantly or most likely refuse doing the MRI, plus it's possible your insurance company will not cover the scan, doctor's fees, etc.

There are two classes, MRI Conditional and MRI Compatible.  I have a Medtronic Advisa DR, and MR Conditional Device due to the necessity of having MR ability.  The leads as well must be MR Conditional or MR Compatable.  There's a difference due to amount of field of testing and what the instrument is rated for.   Your pacemaker cards, the doctor's office, and the mfg. should have your information regarding the device.

Most hospitals will not do them unless they have a team in place--the techs, and advance life support nurse, and an EP tech that can check the programming.  I need to have MRI's, and relying on CT was not efffective, nor as detailed.  Radiation risk is significant.

If your leads can be used, and just the generator replaced then you would be MRI Compatible up to a 1.5T magnet.  I've had 5 MRI's since having the generator replaced.  If the leads are compatible or /conditional then the change-out can be very worth the procedure.  MR is a better diagnostic tool if you need it--understandably for migriaines, brain tumors, and or other illnesses that require a reasonably high level of soft tissue resolution.

If leads need to be replaced, that another story.  Risky, and requires an excellent EP + it needs to be done in a hospital's surgical suite in case of problem.  You have to weigh risk vs. reward, and they people doing the work.  I know for my case, the rewards were worth it--plus the imaging value of MR for tumors is much better, even at 1.5 Tesla.

If I had an older model before 2010, I would not.  Studies have shown a lot of data regarding older machines--and physicians have performed studies with them.  I don't think I'd be the test subject with an older pacemaker.  Look into MR-conditional pacemakers.  If your health can benefit with MR quality, then I think it's reasonable to replace.  Lead extraction is a major procedure, and if the leads woudn't mee requirements, I would hold off.

Good luck!

yes and no

by Tracey_E - 2016-10-22 09:01:23

Yes newer devices are generally considered safe, whether they are mri compliant or not. No, not all leads are safek, that's the catch. For leads that are not mri compliant, it has been shown that it can be done safely but they don't like to do it if the leads are more than 10 years old.

Even if you have an mri safe device, you can't go just anywhere to have an mri. Only some facilities can/will do it and there is a protocol. It's even harder to find a place to do one if your device is newer but not mri compliant, but there are places out there and I know people who have had it done. If your device or leads are older, it would have to be a very compelling reason AND your cardiologist would have to be ok with it AND you'd have to find a place willing to do it. 

I would be wary of a gp that makes a blanket statement that all pacemaker patients can have mri's. 

I was told differently

by NiceNiecey - 2016-10-22 09:45:06

I've had a Medtronic dual lead PM for nearly 3 years.  When I got it, the cardiologist said that because I was "only" 55, he anticipated that at some point in my future, I would need to get an MRI.  Because of that, he was going to implant an MRI compatible device.  That said, the natural assumption is that there are "non-MRI compatible" devices.  

Clarity between conditional and compatible

by Figallegro - 2016-10-22 12:09:47

My new Boston Scientific PM states the PM and Leads are MRI conditional. What is the difference between conditional and compatible so I have a better understanding of what I might allow to be done. Boston Scientific states a need to have a 1.5T MRI enviornment. SAR4W/kg.

Tony

MRI electrophysiologist

by zawodniak2 - 2016-10-22 12:59:20

Several times on the cardiology program on Sirius/XM satallite radio, I have heard Dr. Charles Love,  an elctrophysiologist, who practices at the NYU Langone Medical Center in New York City speak of his work on patients with pace makers.  He said he performs  MRI's on patients with older pace makers and leads.  The only time it can't be done is if one of the leads is fractured or disconnected.  He has also performed over 8,000 lead extractions.  He can be contacted at  212-263-7149

Another, electrophysiologist at that medical center, who has an extensive experience  with pace makers is Dr. Steven Fowler . He can be contacted at 212-263-3600.

                                                  Rodger

Believer

by Cabg Patch - 2016-10-22 16:50:38

Believe what you choose. The doctor was right. You can have an MRI with any Pacemaker, ICD, or CRT and their leads safely. Major hospitals should have a protocol for use of the scanner with a cardiac device. I know a Radiologist who performs MRI's on the heart  of patients with devices on average of 3 times per month.

So believe or not your choice no matter to me.... I'm a believer

What my EP told me...depends

by techiej - 2016-10-22 16:55:51

When I had my PM put in we discussed MRI compatible devices and my EP told me that while he could put one in that unless I knew for certain that I needed to have an MRI he recommended against it as the other devices available would last longer, more programmable, etc.

He also told me that if I ever needed an MRI that some hospitals are equipped to handle PM's like mine.  In my case, Portlands' OHSU was the only one in my metro area that could.  If I needed an MRI to have the Dr contact his office to coordinate.

Against it

by DayStar Open MRI LLC - 2016-10-22 21:23:32

I would recommend against it.

Hector

http://www.daystaropenmri.com

Thanks

by Alma Annie - 2016-10-23 06:08:30

Thank you everyone for your comments and advice.

 I have been told that my pm is not MRI 'friendly'  My local hospital which has a stroke clinic/ward, has said that they would not do one even on a compatible pm as they have run into problems.  I had a TIA some time ago, which is why I went to that clinic.  

I think some GPs might do some research before making statements.  It is impossible for them to know everything about everything.

Alma Annie