Radiologists develop algorithm, contingency plan for MRI in pacemakers patients

As growing numbers of baby boomers enter their golden years, cardiovascular implantable electronic devices (CIEDs) will become even more commonplace than the two million defibrillators and pacemakers currently implanted in Americans.

At least half of those individuals, already experience cardiovascular difficulties, will require MRI during their lifetime. A research team from Changi General Hospital and Singhealth Radiology Singapore have unveiled an algorithm to ensure the safety of CEID patients when undergoing MRI.

“There is an increasing number of patients with CIEDS who will require MRI,” said lead author Pei Ghim Poh, with Changi General. “Radiologists must be able to facilitate the safe utilization of MRI in patients who have CIEDs.”

Published in Insights into Imaging, the review centered on standard practices and protocols to prevent inadvertent scanning of patients with CIEDs.

“Radiologists should have a basic grasp of the principles behind the redesign and engineering of [CEIDs], once considered to be an absolute contraindication to scanning,” Pei et al. wrote.

The plan called for reviewing clinical history, checking for a previous chest MRI and sweeping with a metal detector. If such an incident has taken place, the researchers “propose[d] a contingency plan used in our institution should an inadvertent MR scan of a patient with a MRI unsafe CIED occur.”

The chart has two tracks—one for a scan that occurred during office hours and one for an MRI that had not. In both cases, a clinical incident report should be made within 12 hours so the incidental scan may be reviewed.

Graphics for the various algorithms can be seen here.