Impact of MRI on Leads

How do they prevent the leads from wanting to be pulled out of the heart when in an MRI?


7 Comments

Impact of MRI on leads

by Gemita - 2022-02-09 06:02:38

Good question Stable.  That is what worries me sometimes!

Most new pacemakers and leads are now MRI conditional which means that if certain MRI safety scanning conditions/settings are adhered to by the radiologist, you should remain safe.  They will have strict technical information on scanning conditions to follow.  

It is important that we go to a centre that has expertise carrying out MRIs on patients with pacemakers and that your Cardiologist sends a technician to attend, who will place your device in safe mode before, during procedure and then return to normal mode afterwards and to check your device settings and lead position are unchanged.  They gave my husband an X-ray of position of leads before and after scan, although not all patients receive this attention.  I attach a lengthy MRI link for further reading.

It seems however that many patients even with older leads/pacemakers are able to safely have scans providing the centre carrying out the MRI has experience.  Why do you ask?

https://www.britishcardiovascularsociety.org/resources/editorials/articles/magnetic-resonance-imaging-in-patients-with-cardiac-implantable-electronic-devices-current-recommendations

heating not pulling

by Tracey_E - 2022-02-09 09:28:15

The risk of leads during an mri, according to a friend who is a radiologist, is not the pulling but heating and getting too hot. Newer leads do not do this. 

You've not understood why MRI is an issue for PM/ICD patients

by crustyg - 2022-02-09 09:32:19

Your Q: "How do they prevent the leads from wanting to be pulled out of the heart when in an MRI" implies that you think that the intense magnetic field of the MRI magnet would tear the leads out.  And if the leads were ferromagnetic (which usually means made of iron, but not necessarily) that's exactly what would happen.  There are folk who have little stainless-steel clips on blood vessels (usually in their heads) who can *never* go into an MRI, or even into the same room.  It depends on the quality of the s/steel that was used.  You can sometimes get a small magnet to stick to cheap s/steel cutlery, but good s/steel isn't ferromagnetic.

But they don't use *any* ferromagnetic materials in PMs/ICDs or the leads.

However, the real reason why MRI can be a big problem for some folk with older leads is that the second part of MRI scanning is the repeated pulses of radio waves (which actually tweak the protons into releasing a little pulse of radio as the stimulation stops - and it's this 'squeak' that is used to create the image).  These repeated pulses of radio waves can cause heating of the leads, which could damage the tissue where the leads are embedded.  Modern leads are designed to be unaffected by these pulses.  The 'banging' noises when inside the MRI during a scan is caused by these pulses of radio and the intermittent activation of the search magnets.

Hope that helps.

Magnetic

by AgentX86 - 2022-02-09 13:03:01

As pointed out above, some material is magnetic but, really, most isn't.  If everything were magnetic, the MRI would rip you apart. Even though you have iron in your blood, this doesn't happen.  BTW, good (whatever "good" means in this context) steel can me magnetic.  Good stainless isn't, as evidenced by "stainless steel" appliance fronts The "stainless" rear of ours rotted out because of a leak.  So much for stainless.

In addition to some medical implants, any embedded steel splinters can be a real problem. They will rip through the skin, or eye. They ask this question because many have steel/iron splinters and they can't, for obvious reasons, have MRIs.

 

MRI

by stable - 2022-02-10 23:28:48

My electrophysiologist is concerned that a recent echocardiogram interpretation diagnosis of a 35 to 40 Ejection Factor may be cause for implanting a defibrillator.  He believes that an MRI would provide a measurable EF which will help determine if a combined pacer/defibrillator should be implanted to replace my current Pacemaker.  My existing Leads would have to be removed.  Thank you all for comments as they have been quite helpful.  The article link provided by "Gemita" was very informative.

leads and mri's

by Tracey_E - 2022-02-12 12:01:17

It looks like your leads are from 2016? If that's the case, you can have an MRI! Not every doctor or hospital will be equipped to do it so you might have to do some research to find one, but it absolutely can be done without removing your current leads. Do NOT have lead removal surgery just so you can get an MRI, that's crazy and overkill.

Some leads are labeled MRI safe, but in actuality all leads from the last 10 years or so are safe. They've been doing MRI's on pacemaker patients in Europe for well over 10 years without a single incident. US is behind on this one, but hospitals are catching up. 

Batteries and Leads

by stable - 2022-02-12 22:52:10

Tracey_E, Thanks for your feedback.  My leads were installed in May 2007.  My second pacemaker was installed in 2016 utilizing the original leads.  I agree that I would not have Leads removed to get an MRI.  However, should the MRI results support implantation of a combined PM/DF it is anticipated that new veins would have to be used with new leads thus necessitating the removal of the existing Leads.

Does anyone reading this have any information on hospital MRI departments that are known for performing MRIs on patients with implantable devices (PM and Leadss) in the NY/NJ/PA area??

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