MRI with Pacemaker — EECC MCQ
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Correct answer: C — The device must be reprogrammed to MRI-safe mode (asynchronous pacing or sensing-only) before scanning; MRI must be performed within manufacturer-specified conditions (field strength, SAR limits, scan duration); post-scan device interrogation is mandatory
MRI-conditional CIEDs can undergo MRI safely under specific conditions. The 2021 ESC Pacing Guidelines and manufacturer protocols require: (1) confirm the device is MRI-conditional (check registration card); (2) reprogram to MRI-safe mode: pacing-dependent patients → asynchronous mode (DOO/VOO); non-pacing-dependent → sensing-only (ODO/OVO) to avoid inappropriate inhibition from electromagnetic interference; (3) scan within manufacturer conditions: typically 1.5T only (some newer devices allow 3T), SAR limits <2 W/kg, scan duration limits; (4) continuous monitoring during scan (pulse oximetry, ECG); (5) post-scan device interrogation (check pacing thresholds, lead impedance, battery status). Non-MRI-conditional (legacy) devices may undergo MRI in selected cases at expert centres with specific protocols (Class IIb).
Reference: ESC (2021): Pacing Guidelines; BHRS MRI and CIEDs Guidance