title: Provision of magnetic resonance imaging for patients with 'MR-conditional' cardiac implantable electronic devices: an unmet clinical need.
abstract: OBJECTIVE
  Increasing need for magnetic resonance imaging (MRI) has driven the development of MR-conditional cardiac implantable electronic devices (CIEDs; pacemakers and defibrillators); however, patients still report difficulties obtaining scans. We sought to establish current provision for MRI scanning of patients with CIEDs in England.
  
  
  RESULTS
  A survey was distributed to all hospitals in England with MRI, to assess current practice. Information requested included whether hospitals currently offer MRI to this patient group, the number and type of scans acquired, local safety considerations, complications experienced and perceived obstacles to service provision in those departments not currently offering it. Responses were received from 195 of 227 (86%) of hospitals surveyed. Although 98% of departments were aware of MR-conditional devices, only 46% (n = 89) currently offer MRI scans to patients with CIED's; of these, 85% of departments perform ≤10 scans per year. No major complications were reported from MRI scanning in patients with MR-conditional devices. Current barriers to service expansion include perceived concerns regarding potential risk, lack of training, logistical difficulties, and lack of cardiology support.
  
  
  CONCLUSIONS
  Provision of MRI for patients with CIEDs is currently poor, despite increasing numbers of patients with MR-conditional devices and extremely low reported complication rates.
authors.affiliation: Institute of Cardiovascular Science, University College, London, UK.
authors.forename: Kian
authors.initials: K
authors.lastname: Sabzevari
authors.affiliation: Institute of Cardiovascular Science, University College, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Oldman
authors.affiliation: NIHR Cardiovascular Biomedical Research Department, Barts Heart Centre, Barts Health NHS Trust, London, UK.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Herrey
authors.affiliation: Institute of Cardiovascular Science, University College, London, UK.|NIHR Cardiovascular Biomedical Research Department, Barts Heart Centre, Barts Health NHS Trust, London, UK.
authors.forename: James C
authors.initials: JC
authors.lastname: Moon
authors.affiliation: NIHR Cardiovascular Biomedical Research Department, Barts Heart Centre, Barts Health NHS Trust, London, UK.|Papworth Hospital NHS Foundation Trust, Cambridge, UK.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Kydd
authors.affiliation: Institute of Cardiovascular Science, University College, London, UK.|NIHR Cardiovascular Biomedical Research Department, Barts Heart Centre, Barts Health NHS Trust, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Manisty
mesh_terms: D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004739:England; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006761:Hospitals; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D020380:Needs Assessment; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D061214:Patient Safety; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018570:Risk Assessment; D012307:Risk Factors
keywords: Defibrillator; MR-conditional; Magnetic resonance imaging; Pacemaker; Safety