Nursing

Getting An MRI With A Pacemaker

Getting an MRI if you have a pacemaker is possible today due to MRI conditional pacemakers. In the past, MRI was not allowed in patients with implanted cardiac pacemakers and defibrillators. Thanks to research efforts MRI can now be safely performed in many patients with implanted cardiac devices.

Arrival to the radiology department

When I found out I needed a pacemaker I researched current pacemakers and looked at details such as MRI conditional and battery longevity. My electrophysiologist and I decided the Medtronic Azure was the best option for me. The pacemaker’s average battery life is 14 years, bluetooth compatible, and MRI conditional. Although CT scans are detailed there are certain times when an MRI is the gold standard. Being so young and having health issues I wanted to have the option of getting an MRI if needed.

Fast forward a few months and I got an MRI today! Although my pacemaker is MRI conditional there are a lot of protocols and coordination that went into getting an MRI. I found this out when I tried booking my MRI at an outpatient imaging center, I was told I could only get an MRI within a hospital. I cannot speak for other health-systems as their facilities and protocols may be different but this is my experience. The doctors and hospitals that I typically go to in New York are part of the largest healthcare system in the state. With that in mind only three hospitals in the area are able to perform MRI’s for pacemaker patients. One of them is undergoing construction in their MRI suite so they’re not accepting outpatient appointments . This made getting an appointment kind of a lengthy wait!

My pacemaker card identifying it’s MRI conditional

Besides the MRI having to be be done within a hospital, before I even made my appointment my electrophysiologist had to fill out a pacemaker form and clear me to get an MRI. Once the paperwork was completed and I was deemed eligible the hospital had to coordinate an available appointment with the availability of a Medtronic representative to be there during my MRI. Due to my pacemaker having to go into a certain mode a nurse would have to be present as well to monitor my heart on EKG and pulse oximetry. Once the hospital had all this set up they called my with available dates. One more thing I found out when making my appointment was that my doctor had to order a chest x-ray. They have a protocol in place, before undergoing an MRI they need to confirm proper lead placement.

Heading into MRI

After about three weeks the day arrived for my appointment. I got to the hospital a little early so I could register and get my chest x-ray before the scheduled MRI time. Being a young female they had me complete a pregnancy test since I’d be getting an MRI with Gallium, they have a lot of protocols in place! Once this was completed a nurse inserted an IV so I could receive contrast. Then a Medtronic representative arrived and put my pacemaker into a “SureScan” mode. Following the programming of my pacemaker the nurse put me on EKG and pulse oximetry monitoring. I was finally ready for my MRI….One minute into my MRI, one of my EKG stickers somehow came off my skin. This made my EKG appear as asystole or otherwise known as “flatline”. Being in the machine the nurse could not see what was truly happening so the test had to be momentarily stopped and restarted once they saw that I was fine and replaced the stickers. About 40 minutes later the MRI was completed. The Medtronic representative then reprogrammed my pacemaker and turned off the “SureScan” made. The whole process took about two hours but it went very smoothly and efficiently.

If anyone is interested in the technical requirements and process, below is the radiology checklist from Medtronics website.

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