MRI with MR conditional pacemakers

 

I’m scheduled for an MRI of my right shoulder for rotator cuff pain for several months. I tried to put it off as long as I could but the pain is persistent and moderately limits my daily activities. However, I’m quite apprehensive about the procedure even though my device is MR conditional (Boston Scientific Accolade). I would like any opinions from those who have had MRIs as to what your individual experiences were during or after the MRIs!!! Thank you


10 Comments

MRI's

by new to pace.... - 2023-05-13 23:21:33

I had no problem with MRI's, I have the Medtronic MRI surescan Pacemaker.  First you have to have the MRI done in a hosiptal they will contact the  rep for your Pacemaker as the rep has to be there.  To put the pacemaker in a safe mode, then after return the settings.  The MRI will do nothing for the pain, it is only to see.  I had an xray done to see where the tear was.   Are you planning on haveing surgery done to repair the tear?

I used acpuncture,electric and b-12 shots with botancials to heal my tear.  

new to pace

Effect of magnetic field on the device

by Rch - 2023-05-13 23:50:27

Hi

Thank for your opinions. My main concern is the impact of the powerful magnetic field on the implanted device! Although MR conditional, I'm a bit worried about the possible damage to the pulse generator or the leads by the powerful magnets!!! 

MRI Conditional

by AgentX86 - 2023-05-13 23:58:32

I had to get a letter from my cardiologist telling the radiologist that all is well and that both leads and pacemaker are MRI conditional and the leads match the pacemaker (not a problem if this is the first PM).  The MRI has to be done in a hospital that has a cardiac department.

The hospital I was admitted to originally wouldn't take "yes" for an answer.  They wouldn't touch it.  When I got a neurologist, he was able to get the hospital where he had admitting rights to do the MRI but it took a month to get the paperwork together.

Radiologists hate doing it but will do it  once everything is OK.  Some might be less conservative than others but doctors get sensitive about suits and their license.

Once all that's done, it's a simple procedure but they have to download all of your settings, safe the PM, do the MRI, and then reload your settings.  This is why the hospital needs a cardiac department.  They need a PM tech.  It took me about a half hour, in to out, after was set up.

As always, YMMV.

Having a safe MRI

by Gemita - 2023-05-14 06:54:30

Dear Rch,

I know you are anxious about the safety of MRIs and I can understand this.  We have had many worried members, me included over the last few years about such things as leads being pulled out and device components overheating.  

I attach two links which are good reminders of what checks we need ideally to safely have an MRI and I hope you will find both links comprehensive and helpful.

The risk to leads during an MRI, for example, according to one radiologist in my hospital is not so much about the potential to pull these out but more about the potential for old, abandoned leads, to get too hot. Newer leads do not apparently do this.

My husband has safely had two MRIs (thorax and head) and I have had one MRI spine.  We both have 2018 Medtronic devices and leads that are MRI conditional/safe. Neither of us suffered any adverse effects during or after scanning.  My husband did have a before and after chest X-ray for the thorax MRI to ensure that his device hadn’t moved but this was unusual apparently.  We both had a cardiac technician attend our MRI procedures.

What I would say is that if you attend a main hospital where they carry out many MRIs on pacemaker patients and have a good cardiac team who can attend and place your device in a safe mode for the duration of the scan and then restore your settings to pre MRI values afterwards and other conditions are met, you can be safely scanned, especially with newer devices and leads.  You shouldn’t have to deprive yourself of this excellent imaging modality if it is needed.  Even older devices/leads that are MRI conditional can be safe providing stringent safety checks are followed.

My take home message:  

Go to a main hospital where they carry out many MRI scans on pacemaker patients. Local hospitals and staff may not have the expertise or experience.

Always get written clearance and authority from your cardiologist/EP for you to have an MRI scan and to confirm whether your leads and device are compatible for safe scanning.

Always make sure that a pacemaker technician can attend to prepare you for a safe MRI procedure, to check your pacemaker before and after scanning, to restore any settings and to ensure that there have not been any adverse events.

Good luck Rch, safe scanning and hope your shoulder can be fixed.  

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

https://insightsimaging.springeropen.com/articles/10.1007/s13244-017-0556-3

Just adding support

by Lavender - 2023-05-14 10:11:31

You have endured much pain. You need to investigate this shoulder. The hospital has done this before and will take every precaution. Proceed. The team will watch you closely. Hugs!

MRI

by Julros - 2023-05-14 15:44:31

I had an MRI last year for lumbar radiculopathy. As others said, it went smoothly. The toughest part was getting the hospital to communicate with the cardiology office to get the okay. Even though they are part of the same organization, and share the electronic records, I still had to depend on a paper fax being sent, being seen, and responded to with another paper fax. 

MRI

by doublehorn48 - 2023-05-14 15:54:05

I had a MRI done 8 years ago. My pacemaker was NOT MRI compatible. I had absolutely no problems, other than my being claustrophobic. Where I used to work the work was pretty physical and we had a couple of men that had to have rotator cuff operations on their shoulders. After taking some time off they both came back to work and had no problems.

Thanks

by Rch - 2023-05-15 18:44:55

 

Newtopace,Agent,Gemita,Lavender,Julros and Doublehorn

Thanks for all of your opinions, advice, guidance and moral support. It really helps build up confidence to proceed with the procedure! 🙏

Two MRIs - no problem

by LondonAndy - 2023-05-16 20:00:24

I've had two MRIs since I got a pacemaker in 2013, and am 100% dependent. Both were completed without incident - as others have said, a pacemaker technician attends and puts your device into a basic mode, then restores normal settings afterwards. 

After the second scan I asked the technician if he had ever had a patient have an adverse event whilst having an MRI and he said no. 

The more recent MRI was at St Bartholomew's Hospital in London - one of the oldest hospitals in the world but with a state-of-the-art cardiac centre. They have eight MRI machines. Having the scan is quite a noisy thing, and both of mine took 30 to 40 minutes. The noise is throbbing, and took me a bit by surprise to the extent I wondered if they had been playing music! I think I have danced to similar beats in nightclubs, but it is the MRI machine operating, so don't be alarmed. They will probably give you headphones to both talk to you whilst in the machine, and deaden the noise a bit.

Thanks

by Rch - 2023-05-16 23:30:34

Thanks Andy! My device tech also told me the same thing! Over the 20 years of her practice, she had seen no adverse reactions with either the MR conditional or even the non-MR conditional devices when protocols were strictly followed! 

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