July 11, 2012

For many years, patients with pacemakers could not receive MRIs, which limited their access to this important diagnostic imaging test. Studies have suggested that an estimated 200,000 patients annually in the U.S. have to forego an MRI scan because they have a pacemaker. A new device recently approved by the FDA allows patients to receive MRIs while maintaining the integrity and function of the pacemaker.

“After 13 years of research and a lengthy approval process, we are excited to be ableto offer this to patients,” said Chafik Assal, MD, a cardiac electrophysiologist. “The basic idea behind a pacemaker is to allow individuals do things that they weren’t able to do because of a slow heartbeat. Now, they can experience the improvement in quality of life that a pacemaker offers while still having access to this important imaging procedure.”

Traditionally, pacemakers are made of a material which could heat and cause tissue damage if a patient received an MRI. Also, the magnetic field could stimulate or inhibit the pacemaker’s function leading to an inappropriately high or slow heart beat.

“The new device is made in such a way that the leads [wires] heat much less than traditional pacemakers, and the circuits in the battery minimize interference with the magnetic field,” Assal said. “If a patient with the new type of pacemaker needs an MRI, a technician will program it before and after the test to maintain integrity and safety.”

The procedure to insert the MRI-safe pacemaker is basically the same as a traditional pacemaker. “The leads are different, but there are no additional risks or complications,” Assal said. “If the patient has an indication for a pacemaker, the MRI-compatible pacemaker is usually covered the same as a traditional device.”

MRIs are indicated for many patients, so the approval of the new pacemaker can
benefit many. “Most people that receive pacemakers are 65 or older, and these people may have other conditions – cancer, back problems, nervous system disorders – for which MRIs are necessary. Also, we see many younger patients in their 40s that need a pacemaker, and the chance that they will need an MRI in their lifetime is great,” Assal said.

The decision about which type of pacemaker to implant comes from a thorough discussion with one’s physician. “We have to do this on a case-by-case basis,” Assal said. “While the MRI-safe pacemaker may be the best for some patients, there are features on other devices that can help other patients in different ways. Also, MRI-compatible pacemakers are improved only for dual-lead systems. Patients with atrial fibrillation, the most common irregular heart rhythm disorder, who need a single-lead pacemaker cannot have an MRI-safe one.”

CAMC is home to one of the top heart centers in the nation, performing thousands of diagnostic exams, open-heart surgeries, cardiac catheterizations and electrophysiology and interventional cardiology procedures each year. For more information about cardiac services at CAMC, visit camc.org/heart.

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