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MRI Can Be Safe Even With Implanted Device

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MRI-safe pacemakers? As far as the Johns Hopkins University School of Medicine is concerned, all pacemakers are MRI-safe.

OK, we’re exaggerating. But apparently not by much. Cardiologists at Johns Hopkins say they’ve developed a protocol that has allowed safe MRI scans of patients with pacemakers and defibrillators—older devices, not the new MRI-safe models.

A study published in the October 4 issue of Annals of Internal Medicine details the results of 555 MRI scans performed on 438 patients who had pacemakers or defibrillators. Of the scans, 94 percent were conducted at The Johns Hopkins Hospital in Baltimore. The others took place at Rambam Medical Center in Haifa, Israel.

Henry Halperin, MD, senior author of the study and a professor of medicine, biomedical engineering, and radiology at Johns Hopkins, began testing implanted devices for MRI safety about 15 years ago. According to a Johns Hopkins news release, the safety protocol he developed is now being adopted worldwide.

“The newer pacemakers made after 1998 and defibrillators manufactured since 2000 come with electromagnetic interference protection,” Dr. Halperin said.

The protocol involves prescreening not only the type of device but also its configuration. If a lead is disconnected, for example, MRI is not recommended because the tip of the wire could become too hot.

During an MRI procedure, a nurse with experience in cardiac life support and device programming keeps a close watch on the patient, backed up by an electrophysiologist. Said Roxann Hansford, RN, a study author:

We reprogram the device to a safe mode while the patient is having the MRI scan. We carefully monitor the patient’s blood pressure, electrical activity of the heart, and oxygen saturation, and look for any unusual symptoms. After the test, we reprogram the device and carefully check its function.

Saman Nazarian, MD, the study’s lead author and a Johns Hopkins cardiac electrophysiologist, said, “The guidelines we have published can be used to make MRI more available to people who could benefit from early detection of cancer and other diseases and for guiding surgeons during procedures. MRI is considered superior to CT scans in many clinical scenarios, especially for brain and spinal cord imaging.”

In fact, he said, many patients with implanted devices had tumors or other serious problems diagnosed by MRI at Johns Hopkins—disorders that a previous CT, ultrasound, or other imaging test had missed.

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One Response to “MRI Can Be Safe Even With Implanted Device”

  1. Radiology Daily»AlertArchive » Prostate Radiation Flummoxes Cardiac Devices on October 6th, 2011 at 10:10 am

    […] should check with the Johns Hopkins University School of Medicine cardiologists we discussed in yesterday’s post. They developed a protocol for safely using MRI on patients with implanted cardiac […]