|Ker Boyce, M.D.|
Lacey Moore, M.D.
PINEHURST – Sometimes technologies don’t work together. For years, that has been the case with electronic pacemaker systems, which help regulate the heart beat, and MRI (magnetic resonance imaging) technology.
With the FDA-approved pacing systems now being implanted by electrophysiologists at FirstHealth Moore Regional Hospital, that is no longer the case.
“Until this new device, patients with a pacemaker were unable to undergo an MRI exam,” says Ker Boyce, M.D., an electrophysiologist with Moore Regional and Pinehurst Medical Clinic. “This is an option for those who really need a pacemaker.”
Dr. Boyce did the first MRI-friendly pacing system implant at Moore Regional in mid-2011. The procedures are now also being done by electrophysiologists Rodrigo Bolanos, M.D., also of Pinehurst Medical Clinic, and Mark Landers, M.D., of Pinehurst Cardiology Consultants.
An electrophysiologist is a cardiologist who specializes in the electrical impulses of the heart.
Pacemaker and MRI manufacturers have typically instructed physicians not to expose patients with pacemakers to MRI scans, because the magnetic field of an MRI machine can disrupt a pacemaker’s electronic system, effectively shutting it down or unintentionally stimulating the heart. Some studies also claim that heat generated in the pacing wires by the MRI magnetic and electrical fields could damage cardiac tissue.
The MRI-friendly pacemakers now being used at Moore Regional have been engineered with multiple safety features including circuits that are immune to strong magnetic fields.
Changing health care demographics have had an impact on the increasing need for MRI-friendly pacemakers. According to industry reports, patients over age 65 are the primary users of MRIs and are twice as likely to need an MRI as compared to younger patients.
The elderly also dominate the patient population most likely to need a pacemaker.
According to Lacey Moore, M.D., a radiologist with Moore Regional and Pinehurst Radiology, MRI-friendly pacing systems give these patients the opportunity for imaging exams that previously were unavailable to them.
“Chances are that you are going to need an MRI in your lifetime,” Dr. Moore says. “(This technology) will allow some patients to have scans where otherwise they would not have been able to.”
Medtronic’s Revo MRI SureScan is the only pacing system that has been approved for use in the United States by the FDA. Even then, not all patients, especially those with certain medical conditions, are appropriate for the technology. That’s a decision for the cardiologist and the patient, says Dr. Boyce.
“Still about 50 percent of the patients who require pacemakers will be eligible,” he says.
Scans are also limited to specific areas of the body. And, because of all of the steps in the MRI-pacemaker protocol (including a clear identification of the system as MRI-friendly), most procedures are elective.
A traditional pacing system will cost the patient about $7,000, while the MRI-friendly system will add about $500 more.
“If you’re a person who thinks you might need it, the price probably won’t matter,” Dr. Moore says.
With health care’s increasing reliance on MRI technology as a dependable and efficient diagnostic tool, Dr. Moore expects traditional pacemakers will eventually be phased out in favor of the MRI-friendly systems, especially as numerous manufacturers work to develop their own programs.
“Chances are you are going to need an MRI in your lifetime,” he says. “Eventually, it’s going to be standard to have (a pacemaker) of this type.”