1. Posted by A Yahoo! Health User on Fri, Aug 07, 2009, 1:38 pm PDT

This is great news for me about the MRI and pacemakers. No more MRI for me. I have been thinking about asking this question myself.Thanks for this great informative article

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2. Posted by A Yahoo! Health User on Sat, Aug 15, 2009, 9:36 am PDT

I would love to know the real answer about ICDs and electric or hybrid cars. I've gotten 3 different answers from my pacemaker clinic, St. Jude's (the company that made my ICD) as well as one of my cardiologists. I've also read there is the posibility of defibrillator shock. It's scary because I already had my ICD leads pull out and shock me over 65 times so I would really appreciate an honest answer.

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3. Posted by A Yahoo! Health User on Sat, Aug 29, 2009, 8:46 am PDT

Alas, I believe that Dr Margolis is unfamiliar with the literature on this subject. Any patient with a cardiac pacemaker or defibrillator CAN undergo an MRI provided that certain steps are taken. Yes, the scan will likely be more risky (depending upon the patient's condition, the device type (pacemaker or ICD), and the device manufacturer. ALL of medicine and medical decision making is balancing risks and benefits. For a patient with some unknown medical issue that can be answered only by MRI, then perhaps the benefit might outweigh the risk. Several medical centers throughout the US and the world are performing MRI scans in cardiac pacemaker or defibrillator (ICD) patients. To date, over 600 patients have been scanned (and reported) in a very special setting, and no significant untoward events have been observed. There has been no generator movement, no generator heating, and no need for a replacement in any of these cases. No patient has appeared to be injured. But remember that each of these scans has taken place with a pacemaker / ICD physician present for the entire MRI. I have attached a bibliography for those who might not believe my post. Remember that very few MRI centers are doing these scans, as these scans require considerable coordination among several medical services, some of which might not be available at an MRI center. And further, at this time, I believe that every one of these scans must have a pacemaker physician present to monitor the patient and the pacemaker or ICD. Reference List 1. Ali RJ, Reeves WC, Movahed A. Pharmacological stress agents for evaluation of ischemic heart disease. Int J Cardiol 81:157-67, 2001 2. Del ojo JL, Moya F, Villalba J et al. Is Magnetic Resonance Imaging Safe in Cardiac Pacemaker Recipients? Pacing Clin Electrophysiol 28:274-78, 2005 3. Dewey M, Schink T, Dewey CF. Frequency of referral of patients with safety-related contraindications to magnetic resonance imaging. Eur J Radiol 63:124-27, 2007 4. Dill T. Contraindications to magnetic resonance imaging: non-invasive imaging. [Review] [25 refs]. Heart 94:943-48, 2008 5. Faris OP, Shein M. Food and Drug Administration perspective: Magnetic resonance imaging of pacemaker and implantable cardioverter-defibrillator patients. Circulation 114:1232-33, 2006 6. Faris OP, Shein MJ. Government Viewpoint: U.S. Food & Drug Administration: Pacemakers, ICDs and MRI. Pacing Clin Electrophysiol 28:268-69, 2005 7. Ferris NJ, Kavnoudias H, Thiel C et al. The 2005 Australian MRI safety survey. AJR Am J Roentgenol 188:1388-94, 2007 8. Fiek M, Remp T, Reithmann C et al. Complete loss of ICD programmability after magnetic resonance imaging. Pacing Clin Electrophysiol 27:1002-4, 2004 9. Fisher JD. MRI: Safety in Patients with Pacemakers or Defibrillators: Is It Prime Time Yet? Pacing Clin Electrophysiol 28:263, 2005 10. Gimbel JR, Wilkoff BL, Kanal E et al. Safe, sensible, sagacious: responsible scanning of pacemaker patients. Eur Heart J 26:1683-84, 2005 11. Gimbel JR. Magnetic resonance imaging of implantable cardiac rhythm devices at 3.0 tesla. Pacing Clin Electrophysiol 31:795-801, 2008 12. Gimbel JR, Johnson D, Levine PA et al. Safe performance of magnetic resonance imaging on five patients with permanent cardiac pacemakers. Pacing Clin Electrophysiol 19:913-19, 1996 13. Gimbel JR, Kanal E. Can patients with implantable pacemakers safely undergo magnetic resonance imaging? J Am Coll Cardiol 43:1325-27, 2004 14. Gimbel JR, Bailey SM, Tchou PJ et al. Strategies for the Safe Magnetic Resonance Imaging of Pacemaker-Dependent Patients. Pacing Clin Electrophysiol 28:1041-46, 2005 15. Gimbel JR, Kanal E, Schwartz KM et al. Outcome

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