Information for patients

If you are a patient reading this and have a concern about an MRI scan you are scheduled to attend, we strongly recommend you contact the site where your scan is due to take place, you may also wish to refer to our ‘Information for Patients’ section. Please note local variations to the policies detailed on this website may apply, therefore please contact the hospital where your appointment is scheduled for clarification.

Disclaimer (MUST READ)

The MRI safety information contained within this webpage is intended for use by staff from NHS Greater Glasgow and Clyde (GGC) and associated health boards, namely: NHS Ayrshire and Arran, NHS Borders, NHS Dumfries & Galloway, NHS Forth Valley, NHS Golden Jubilee, and NHS Lanarkshire. Only staff from these health boards are approved to use this information and local variations to the policies detailed may apply.  Non-approved users i.e. patients and staff from health boards other than those listed above, or staff from private medical organisations use this information at their own risk. We, NHS GGC, accept no responsibility for patient injury or adverse outcomes that may occur as a consequence of the information contained herein. If you have any questions regarding this disclaimer, please contact the NHS GGC MRI physics team on: ggc.MRSafetyExpert@nhs.scot​.

NHS GGC MRI safety policy for scanning patients with cardiac pacemaker or defibrillators 

Must read: What this policy does not cover / notable exceptions

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Must read: What the policy covers

Guidance is provided below as to how to proceed when one is faced with an MR request for a patient with a cardiac pacemaker or defibrillator unit. 

Must read: The MR safety policy

If a patient with a pacemaker or defibrillator is being considered for MRI then the first thing to be done is to discuss the patient case with a Radiologist to ensure the referral is valid. Beyond this, the make and model of the device must be known and documented proof must be sought. Note that the make and model of both the pacing device and the leads must be known.

If the device (the pacing or defibrillator unit AND lead combination) is determined to be an MR Conditional device, the MR Conditional criteria must be sought and thought should begin as whether or not these conditions can be satisfied. That is, it will be necessary to work with colleagues from cardiology to co-ordinate the imaging of these patients and for them to assist in satisfying the MR Conditional criteria. The patient may only be scanned after all of MRI conditional criteria are satisfied. The specific conditions will depend on the device in question.

If the device and lead combination is not known to be an MR Conditional pacemaker, then it must be assumed to be MR Unsafe. Scanning a patient with such a device would represent an off-label process where the risks are not insignificant. In this scenario, a Radiologist (in conjunction with the Referrer as required) should be consulted to determine if there is an alternative imaging modality that can answer the clinical question, or indeed an alternative ongoing management for this patient. Currently, NHSGGC does not have the necessary processes and service provision in place to enable routine MR scanning of these devices, however in specific cases of exceptional clinical need a discussion of risk/benefit could be undertaken and a risk assessment produced with the agreement of Radiology, MRI Physics and Cardiology which may enable scanning to take place.​

Risk assessment: A risk assessment underpinning this policy can be found here: 

GenericRiskAssessmentForm_MR_scanning_MR_Conditional_pacemakers

Additional background  information and discussion

See the following links on MRI safety of …

Scanning patients with pacemakers is one of the greatest causes for concern in MRI. Patients with pacemakers have died as a result of being taken into the MR Environment. For many years, many MRI units, including those in NHS GGC, had an absolute ban on MR imaging of patients with pacemakers due to concerns about safety.

Many pacemakers still being implanted today are MR Unsafe devices. While there is still reason for caution, the advent of MR Conditional pacemakers means it is no longer reasonable to preclude all patients with pacemakers from MRI as a healthcare technology on the grounds of safety. MR Conditional pacemakers have been specifically designed and tested for safe use in MRI.