Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators
Objective To determine provision of MRI for patients with cardiac implantable electronic devices (CIEDs; pacemakers and defibrillators) in England, to understand regional variation and assess the impact of guideline changes.Methods Retrospective data related to MRI scans performed in patients with C...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001598.full |
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| _version_ | 1846166548767571968 |
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| author | James C Moon Deepa Gopalan Charlotte Manisty Anish Bhuva Giles H Roditi Aderonke Abiodun Christopher Pieri Russell Moralee |
| author_facet | James C Moon Deepa Gopalan Charlotte Manisty Anish Bhuva Giles H Roditi Aderonke Abiodun Christopher Pieri Russell Moralee |
| author_sort | James C Moon |
| collection | DOAJ |
| description | Objective To determine provision of MRI for patients with cardiac implantable electronic devices (CIEDs; pacemakers and defibrillators) in England, to understand regional variation and assess the impact of guideline changes.Methods Retrospective data related to MRI scans performed in patients with CIED over the preceding 12 months was collected using a structured survey tool distributed to every National Health Service Trust MRI unit in England. Data were compared with similar data from 2014/2015 and with demand (estimated from local CIED implantation rates and regional population data by sustainability and transformation partnerships (STPs)).Results Responses were received from 212 of 223 (95%) hospitals in England. 112 (53%) MRI units’ scan patients with MR-conditional CIEDs (10% also scan non-MR conditional devices), compared with 46% of sites in 2014/2015. Total annual scan volume increased over fourfold between 2014 and 2019 (1090 to 4896 scans). There was widespread geographical variation, with five STPs (total population >3·5 million representing approximately 25 000 patients with CIED) with no local provision. There was no correlation between local demand (CIED implantation rates) and MRI provision (scan volume). Complication rates were extremely low with three events nationally in 12 months (0·06% CIED–MRI scans).Conclusions Provision of MRI for patients with CIEDs in England increased over fourfold in 4 years, but an estimated 10-fold care gap remains. Almost half of hospitals and 1 in 10 STPs have no service, with no relationship between local supply and demand. Availability of MRI for patients with non-MR conditional devices, although demonstrably safe, remains limited. |
| format | Article |
| id | doaj-art-74ccbfe092344a0d992cfd0e20ec6906 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-74ccbfe092344a0d992cfd0e20ec69062024-11-15T14:00:09ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2021-001598Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillatorsJames C Moon0Deepa Gopalan1Charlotte Manisty2Anish Bhuva3Giles H Roditi4Aderonke Abiodun5Christopher Pieri6Russell Moralee72UCL Institute of Cardiovascular Science, University College London, London, UK3 Department of Radiology, Imperial College Healthcare NHS Trust, London, UK7University of ManchesterNHS, Flat 3, Hillgrove House, 186A, High Street, London, LND HA8 7EX, UKRadiology, NHS Greater Glasgow and Clyde, Glasgow, Glasgow, UKDepartment of Cardiology, Barts Health NHS Trust, London, UKInstitute of Health Sciences, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UKDepartment of Radiology, Imperial College London, London, UKObjective To determine provision of MRI for patients with cardiac implantable electronic devices (CIEDs; pacemakers and defibrillators) in England, to understand regional variation and assess the impact of guideline changes.Methods Retrospective data related to MRI scans performed in patients with CIED over the preceding 12 months was collected using a structured survey tool distributed to every National Health Service Trust MRI unit in England. Data were compared with similar data from 2014/2015 and with demand (estimated from local CIED implantation rates and regional population data by sustainability and transformation partnerships (STPs)).Results Responses were received from 212 of 223 (95%) hospitals in England. 112 (53%) MRI units’ scan patients with MR-conditional CIEDs (10% also scan non-MR conditional devices), compared with 46% of sites in 2014/2015. Total annual scan volume increased over fourfold between 2014 and 2019 (1090 to 4896 scans). There was widespread geographical variation, with five STPs (total population >3·5 million representing approximately 25 000 patients with CIED) with no local provision. There was no correlation between local demand (CIED implantation rates) and MRI provision (scan volume). Complication rates were extremely low with three events nationally in 12 months (0·06% CIED–MRI scans).Conclusions Provision of MRI for patients with CIEDs in England increased over fourfold in 4 years, but an estimated 10-fold care gap remains. Almost half of hospitals and 1 in 10 STPs have no service, with no relationship between local supply and demand. Availability of MRI for patients with non-MR conditional devices, although demonstrably safe, remains limited.https://openheart.bmj.com/content/8/1/e001598.full |
| spellingShingle | James C Moon Deepa Gopalan Charlotte Manisty Anish Bhuva Giles H Roditi Aderonke Abiodun Christopher Pieri Russell Moralee Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators Open Heart |
| title | Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators |
| title_full | Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators |
| title_fullStr | Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators |
| title_full_unstemmed | Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators |
| title_short | Access to MRI for patients with cardiac pacemakers and implantable cardioverter defibrillators |
| title_sort | access to mri for patients with cardiac pacemakers and implantable cardioverter defibrillators |
| url | https://openheart.bmj.com/content/8/1/e001598.full |
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