How soon have you had an MRI after generator change?

I just got a Medtronic Azure XT DR this morning to replace an Advisa with low batteries. Easy peasy! I haven't even needed a Tylenol.

I need to have two MRIs. One for my brain, and that one's overdue. It's part of follow-up for the brain surgery I had last August. The other is because my liver is acting up, and they haven't figured out exactly why yet.

The Medtronic policy is apparently that I will have to wait six weeks post-surgery, even though the leads are not an issue (they leave those and plug them into the new unit, so they're as embedded my heart as they will ever be). The MRI nurse told me that the doctor might be able to override that. I'm not 100% certain that's a good idea, as I had slow healing of the pocket before. But I'd like to know my options. I have other procudures on my eyes that will happen after these are cleared, so I'd like to get the ball rolling.


3 Comments

how long before MRI

by new to pace.... - 2024-03-26 23:12:33

How long before MRI, That part i do not know.  For me  to get an MRI have to have it done in a Hosiptal . Need an order from the doctor who is requesting it.  Then have to get clearance from Cardiologist.  Then it goes to the Risk Management at the hospital who has to approve.  Since you need 2 different ones.  At least where i go , If they  are within 45 days.  Do not need to get approval again. Otherwise i would have to go though everything again.  Medicare will only approve 2 parts of my body at a time. Needed a shoulder and then a spine.  2 different days.

new to pace

MRI safety

by Gemita - 2024-03-27 03:31:01

Elisabet, firstly, I am so glad your device change was a piece of cake!   That is reassuring for so many of us.  You have partially answered your own question about the MRI:

“The Medtronic policy is apparently that I will have to wait six weeks post-surgery” 

so you will need to discuss this carefully with “all” your medical teams involved in your care (and Medtronic of course) to see whether you can safely go ahead earlier than 6 weeks, or whether you can safely wait for your procedure?  

I would imagine the main concern is the potential for the device to move within the pocket, perhaps pulling on leads, impairing communication between the electrodes and the generator.   As you say, your old leads are well embedded into heart tissue, but your replacement device ideally needs 6 weeks to settle into the pocket and to be held firmly in place?  

As you know a cardiac technician will place your device into a safe mode before scanning and then restore the settings to their former values afterwards.  I attach a good general link in case it is of help.  This should be copied into your main browser to open.  

From my additional research, it would appear that several device manufacturers recommend that MRI should not be performed sooner than 6 weeks after implantation and that no doubt includes replacement devices. Nevertheless, the risk for lead and generator movement is still extremely low, and imaging may be performed earlier on a case-by-case basis if there is a clinical necessity.  There needs to be a multi-disciplinary team meeting held between your health professionals to discuss your situation to come to the best decision. 

I would be extremely interested to hear what your team decide.  I hope you stay safe during scanning and I wish you all the very best Elisabet

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

Thanks Gemita!

by Elisabet - 2024-03-27 22:25:15

Yeah, the word was that I could have it done sooner if there was "medical necessity". When I go to the device follow-up in a couple of weeks I plan to bring up the timing with the doctor. They did a blood draw in pre-op and my liver enzymes were considerably higher than they were even a couple of weeks earlier. Basically they are increasing at an exponential rate so I don't want to put that test off any longer than I have to. I was really hoping they could do it before I had the generator replaced, but no dice. The doctor investigating my liver issue is aware of the new numbers, and he hasn't jumped in yet.

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