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MRI with Cardiac Devices — EECC MCQ

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EasyCardiac DevicesMRI with Cardiac DevicesEECC

A 75-year-old woman with sick sinus syndrome and a permanent pacemaker is scheduled for an MRI of the lumbar spine. Her device is documented as an MRI-conditional pacemaker system. What precautions are required?

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Correct answer: A — Programme the device to MRI-safe mode, perform the scan within the conditions of use, and reprogram the device post-scan

MRI-conditional pacemakers can safely undergo MRI scanning provided specific conditions are met: (1) The device is reprogrammed to 'MRI-safe' mode (typically asynchronous pacing or sensing-only mode with tachytherapy suspended in ICDs); (2) The scan is performed within the manufacturer's conditions of use (specific SAR limits, 1.5T vs 3T restrictions, no leads meeting exclusion criteria); (3) The patient is monitored during the scan; (4) The device is interrogated and reprogrammed to normal settings post-scan. MRI-conditional systems are not 'MRI-safe' without these precautions — they require active device management. Legacy (non-MRI-conditional) devices may still undergo MRI at experienced centres under strict protocols.

Reference: BHRS Guidelines on MRI with Cardiac Devices; Manufacturer conditions of use