21 October 2024

ASMIRT recently produced a new position paper, MRI Scanning and MR-Conditional Pacemakers. This comes as some medical device companies suggest radiographers can independently set patients’ pacemakers to MRI mode, prior to an MRI scan.

Around 200,000 Australians have a pacemaker or other type of cardiac implantable electronic device (CIED).¹ CIEDs may or may not be MRI-conditional, that is, safe for use in the MRI environment under strict conditions.

At this point in time, altering a patient’s CIED is outside the scope of practice for medical radiation practitioners (MRPs).

Usually, when someone with a CIED needs an MRI scan, a cardiologist or cardiologist’s trained delegate would:

• Check the CIED is MRI-Conditional
• Check all components are functioning normally (also known as interrogation)
• Program the CIED to MRI mode
• Once the scan is complete, set the CIED back to normal operation

Without proper training, this could be very dangerous – a patient whose CIED malfunctions is at increased risk of heart failure. As standard MRP education omits training in this area, interrogating and programming a CIED is outside of MRP scope of practice – it isn’t appropriate for an MRP to undertake this responsibility.

New responsibilities can enter into an MRP’s scope of practice only after completing appropriate theoretical and practical learning and credentialling.

ASMIRT recommends MRPs consult with their workplace regarding training and credentialling, organisation or departmental processes, consent processes, and stakeholder agreement (radiologists, cardiologists, nursing staff, etc) prior to undertaking CIED-related duties.

Read the ASMIRT Position Paper on MRI Scanning and MR-Conditional Pacemakers here:

Safety Considerations

Regardless of which qualified professional interrogates and programs the CIED, MRI departments should follow safety procedures including:

• MRI scans should occur during normal operating hours where enough trained personnel are available to assist and respond to any incidents that may occur.
• Obtain CIED details from the patient’s cardiologist.
• Obtain consent to program the CIED to MRI mode from the patient’s cardiologist.
• Obtain and record consent from the patient.
• Record/document the interrogation and programming of the CIED before and after the scan.
• A nurse with Advanced Life Support/ cardiac training monitors the patient during and after the scan.

1 https://www1.racgp.org.au/ajgp/2018/may/cardiac-rhythm-management-devices