This article purposes to articulate the relationship and interaction between magnetic resonance imaging (MRI) on one hand and implantable cardiac systems such as pacemakers and defibrillators on the other. The authors appear to stimulate the medical fraternity and manufacturers of cardiac systems to develop devices that can be used in any type of environment, including the MRI environment. According to Kalin & Stanton (2005), an estimated 50–75 percent of patients with cardiac devices could actually benefit from the many advantages of MRI in diagnosing a multiplicity of health-related issues. Nevertheless, the patients cannot use MRI due to the noted health risks.
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This article is relevant to MRI in as far as it attempts to outline how pacemaker and Defibrillator patients can benefit from MR scans if the required medical framework of ensuring safety is put in place. The authors are categorical in asserting that MRI has progressively become the imaging system of choice for comprehensive clinical evaluation and detection, including diagnosing defects of the cardiovascular system (Kalin & Stanton, 2005). The Imaging system, however, has been noted to interfere with various implantable heart devices, and the article vividly demonstrates the negative interactions of an MR scan on patients with implantable cardiac devices.
List of Key Concepts
- MR scanning can assist in diagnosing a multiplicity of health conditions, and patients on pacemakers and defibrillators can benefit if safer techniques are invented to perform scans on them without affecting the implantable devices.
- Static magnetic fields may occasion problems when MRI is used on patients with implantable devices by applying mechanical forces on the devices’ ferromagnetic constituents
- The pulsed radiofrequency field sent from the MRI system may occasion the pacemaker to over-sense, leading to ether potentially fatal thermal injury at the tissue abnormal pace.
- The gradient magnetic fields from the MRI system can stimulate unwarranted voltages on leads, leading to over-sensing or under-sensing of the pacemakers.
- The above scenarios occasions potential risks, which include pacing capture failure; abnormal temperature increases; electrical reset on the implantable pacemakers; post-interrogation problems; changes in pacing thresholds; changes in leads thresholds; severe injury; and death
Strengths and Weaknesses
Through the employment of previous studies conducted by other researchers, the article has successfully brought to the fore the intricate relationship and interaction between MRI systems and implantable heart devices. The article has also scored a first in outlining what needs to be done to correct the situation, including the development of devices that will ensure the safety of patients even in MRI environments. The article, however, has extensively used secondary sources of information to come up with its conclusions, leaving it exposed to researchers’ bias and errors. The authors could have conducted a primary study to ascertain the facts. The article can also be accused of being too brief to offer the necessary credibility to the weighty issues being discussed.
The authors use secondary resources to support their viewpoints. In particular, they use previous studies of Ruguin et al, Martin et al, and Gimbel and Kanal to form the groundwork for their analysis. These secondary resources evaluate how MRI examinations relate and interact with implantable heart devices and the possible ramifications that may arise (Kalin & Stanton, 2005)
Heart-related conditions continue to present a lot of challenges to the medical fraternity. As such, any strategies that are undertaken to bring relief to the patients should be welcome. MRI interventions can assist in diagnosing heart-related conditions, but to date, these interventions present several glaring health risks to patients using implantable heart devices such as pacemakers and defibrillators. As such, doctors need to be on the lookout for possible side effects when performing an MR scan on patients using the devices. They shouldn’t generalize the current devices as safe merely because some experiments have shown them to be safe as this may compromise the safety of the patient. Manufacturers of these devices must also work overtime to ensure that the cardiac devices entering the market are safe for use in any type of environment, including an MRI environment. As such, I agree with the Authors’ conclusions.
Kalin, R., & Stanton, M.S. (2005). Current clinical issues for MRI scanning of pacemaker and defibrillator patients. PACE, Vol. 28