Mixed MRI-conditional System — EECC MCQ
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Correct answer: E — The system as a whole is NOT MRI-conditional — all components (generator AND every lead) must be MRI-conditional for the system to be scanned safely; a non-MRI-conditional lead renders the entire system non-conditional regardless of the generator status
MRI-conditional status applies to the COMPLETE system (generator + ALL leads): every component must be individually MRI-conditional AND the specific combination must be validated by the manufacturer. If ANY component is non-MRI-conditional (as in this case — the 2015 non-conditional lead), the entire system is classified as non-conditional. MRI in non-conditional systems: (1) previously considered absolutely contraindicated; (2) now may be performed at experienced centres with specific safety protocols (Class IIb in ESC 2021 Pacing Guidelines) — requires: dedicated MRI-CIED programme, appropriate device programming, continuous monitoring during scan, limited SAR, and informed consent regarding elevated risk. The 2021 ESC Pacing Guidelines state that 'non-conditional' does not mean 'absolutely contraindicated' but does mean 'off-label with increased risk requiring specialist assessment.'
Reference: ESC (2021): Pacing Guidelines; BHRS MRI Guidance