Hi! It's been a long time since I've been on the site- mostly because things have been going well since I had my first PM implanted in 2007. I had my device changed out in 2018 to one of the Medtronic MRI compatible devices and my leads are the originals that were placed in 2007.  

So my question is "what good is it to have an MRI compatible device if the leads haven't been changed?"  I'm having some back problems that are usually checked by MRI, but I'm thinking old leads might just "fry" my heart.  Am I way off base on this fear?  
I did mention this in passing to my EP after getting the new device and he just nonchalantly said "oh the leads are already MRI safe". I'm not convinced. Any thoughts??




Your leads are either classified as MRI-compatible or not

by crustyg - 2021-05-11 03:07:51

You are correct that it's the entirety of the system that controls whether you will be classed as MRI-safe or not.

At least, in theory, leads that were already MRI-compatible now connected to a new, MRI-safe PM box should make you safe to be scanned with this tech, but in practice you will find that the imaging department will be the final arbiters of whether they let you into their machines or not.

The issue with the leads inside the extremely powerful magnetic field of the MRI isn't actually about whether they contain any ferromagnetic material (e.g. iron) which would cause them to rip out of their locations, but the powerful radio-frequency energising pulses which pump energy into the protons of the nuclei of our atoms - these RF pulses can cause significant heating of leads not designed to avoid this - and that's not good for you.

The imaging folk are more cautious than you are, so you are the one likely to be the supplicant pleading to get the MRI done.  My completely MRI-safe set up, all documented, still took nearly 2months to gain acceptance before I was allowed to have a cervical spine MRI which proved what the CT-scan couldn't.

MRI "Compatible"

by AgentX86 - 2021-05-11 22:06:11

The term isn't "MRI compatible", rathr "MRI conditional".  The difference in words tells it all.  "Conditional" means "if the stars align just so".  Everything must be supported by the manufacturer, in combination, before the manufacturer will stand behind the implant.  Old leads with a new generator may not have been tested in that combination.  Certainly leads from one manufacturer and a generator from another is going to be problematic.

A Crusty points out, even then the radiologist may be reluctant to perform the MRI.  It's his call.  I needed an MRI while I was on a vacation a couple of years ago.  The radiologist where I was had no interest in taking any risks.  They gave me a CAT scan and sent me on my way.  When I got home it tooks a month to convince a local hospital (where my neurologist practices) to do it, and then only after my hospital, EP, and cardiologist signed off on the procedure.  It was a real PITA.  Add the complications of mismatched generator and leads, you may have a real problem.

Push, push, and push some more.  The first thing you're going to have to do is get your EP behind you.  You may need him to contact the manufacturer on your behalf.

An MRI comparable device with non-compatible leads is pointless!

by asully - 2021-05-13 01:03:31

I have had exactly that since my second device (on my third now).  But two of my leads are NOT MRI safe.  They had to confirm this prior to my last big procedure.  I am glad I know about the leads now because many doctors might have overlooked that on the basis that my device was MRI safe.  But yes it seems silly.

Apparently had I had an MRI it may not have turned out so well.  I would get a number of opinions before you decide it is safe.  Better safe than sorry.

Thank You

by Carol - 2021-05-15 16:33:14

Thanks to all that responded to my inquiry regarding the safety of getting an MRI (or not).  These were my thoughts and misgivings as well.  I'm probably stuck with the "old school" way of getting diagnosed CT scan.  
I didn't realize that the radiology departments have the last word but it makes sense. Afteralll, who wants to be on duty when your patient's heart begins to smoke😉. 

Thanks again!!


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