digest
Short Summary
Main recommendation: Dr. Jeffrey Anderson says a new study shows MRIs can be performed safely on patients with pacemakers and defibrillators under carefully monitored conditions, and he believes insurers should cover them. The Intermountain Medical Center study found no pacemaker failures across 212 MRIs in 178 patients, and its authors have asked Medicare and Medicaid to cover medically necessary scans for these patients.
Key Points
- A 2014–2016 Intermountain Medical Center Heart Institute study, led by Dr. Jeffrey Anderson, reviewed 178 patients with a pacemaker or defibrillator who received 212 MRIs.
- The study found no pacemaker failures, which Dr. Anderson says supports his conclusion that MRIs can be done safely with these devices.
- MRIs use magnetism and magnetic waves rather than radiation, and are described as more precise than other technologies for assessing soft tissue.
- The study covered devices dating back to 2000, while only newer approved devices implanted since 2011 are covered by insurance in every case; Dr. Anderson says the study shows MRIs are safe for all these patients, including those with older devices.
- About 3 million people in the United States have a pacemaker or defibrillator, and at least half will need an MRI during their lifetime.
- Dr. Anderson's team and the researchers behind a related study have submitted letters to Medicare and Medicaid asking them to cover medically necessary MRIs for these patients.
Details Worth Noting
- Concrete instructions: The study's approach was to monitor patients carefully before, during, and after each scan. According to Dr. Anderson, standard pacemakers and defibrillators do not need to be replaced through surgery with an MRI-approved device before a scan.
- These devices are not officially approved for MRI imaging, which is why the study matters for coverage decisions.
- Some patients have been denied MRIs or told to get a less detailed image or x-ray before surgery, which the study's authors say affects surgical planning.
- Jack Pickerel, 85, of Salt Lake, needed back surgery and received an MRI and surgery in May of the year the story aired, after doctors initially said he could not have one due to his pacemaker.
- The video notes that some patients would like the scan but cannot pay for it out of pocket, which is part of the argument for insurance coverage.
Bottom Line
The study suggests MRIs are a safe option for many people with implanted cardiac devices when monitored closely, and coverage policies may need to catch up with that evidence.
