Safety of MRI Scans for Individuals with Pacemakers or Implanted Devices
In recent years, advancements in medical technology have made it possible for most heart valves and coronary artery stents currently on the market to be safely scanned using Magnetic Resonance Imaging (MRI) and Computed Tomography (CT). However, the safety guidelines for these scans in patients with implanted cardiac devices such as pacemakers or defibrillators depend on whether the device is MRI-conditional or non-MRI conditional.
MRI Scans
For patients with MRI-conditional cardiac devices, it's essential that these devices are programmed to an MR "safe" mode before scanning. This programming should be done by a trained cardiologist or cardiac physiologist and includes recording device and lead parameters beforehand. MRI scans should be performed only when clinically necessary in patients with non-MRI conditional devices and preferably at centers with expertise in scanning such patients.
Some leadless pacemakers are conditionally safe for MRI when scanned following strict protocols outlined in their manuals. However, deviations from these protocols can cause severe injury or device malfunction. It's crucial to know the manufacturer, model name, and model number of an implanted device, as this information is necessary for safe MRI scanning.
Patients must inform the imaging center about implanted devices before scheduling. Centers implanting such devices are expected to have protocols to allow timely and safe MRI access for patients with MRI-conditional devices. MRI involves strong magnetic fields and radiofrequency energy, which can induce electrical currents or cause heating in metal devices. Modern pacemakers have less ferromagnetic material, reducing risks, but precautions and proper device reprogramming remain crucial.
CT Scans
CT scans use X-rays, not magnetic fields, so they generally pose less risk to patients with implanted cardiac devices than MRI. However, patients should still inform imaging and clinical staff about the device to ensure proper precautions. Although the CT scan will not affect your device, if it's on the larger side, your device can sometimes affect image quality.
General Precautions
Presenting the patient ID card related to implanted devices before any imaging procedure is essential. Ensuring devices are checked before and after imaging for proper functioning is also crucial. Using sedation or pre-scan counseling if needed for claustrophobia or patient comfort, especially with MRI scans, is also recommended. Avoiding MRI scan unless the potential benefits outweigh the risks, especially in non-conditional device patients, is a prudent approach.
In summary, MRI scans can be safely performed in patients with MRI-conditional pacemakers or defibrillators when proper device reprogramming and safety protocols are followed. Non-MRI conditional devices require more specialized assessment and a cautious approach. CT scans are generally safer for these patients but all implanted device information must be fully disclosed to imaging staff to ensure safety.
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