MRI for patients with cardiac implantable electronic devices

Magnetic resonance imaging (MRI) is fundamental to healthcare, particularly for diseases of the central nervous system, musculoskeletal disorders and cancer diagnosis and treatment (surgery, radiotherapy). In England, 2.9 million scans are performed annually and it is the fastest growing imaging modality at 12% annually.

However, nearly one in 50 of the UK population over 65 has a permanent pacemaker (PPM) or implantable cardioverter defibrillator (ICD). These are collectively termed cardiac implantable electronic device (CIED). Historically, MRI has been contraindicated for safety. Each of these half a million individuals has an estimated need for MRI in their lifetime of 50-75%. This has led to two major developments. Firstly, the manufacture of MRI-conditional devices and secondly development of algorithms to all but eliminate risk when scanning non-MRI conditional ‘legacy’ devices. Unfortunately the increase in demand has not been met by supply; provision of MRI services for CIED patients in the UK remains grossly inadequate, leading to a growing inequality of care for this growing patient group.

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