11
• Is it reasonable for a patient with an MRI nonconditional CIED system to
undergo MR imaging if there are no fractured, epicardial, or abandoned
leads, the MR is the best test for the condition and there is an institutional
protocol and a designated MR-responsible physician and CIED physician.
(IIa/B-NR)
• Reasonable to perform MR scan immediately after implant if clinically
warranted (IIa/B-NR)
• MR-responsible physician notified (I/C-EO)
• Monitor ECG and pulse oximetry (I/B-NR) and continue until baseline or
appropriate settings restored after imaging (I/C-EO)
• Defibrillator/monitor with external pacing function and programmer
immediately available in patient holding area (I/B-NR) and any
resuscitative efforts that involve MR-unsafe equipment would be
performed after moving the patient outside of Zone 4 (I/C-EO)
• Personnel with skills to perform ACLS in attendance during the time the
patient is reprogrammed and until assessed and declared stable to return to
unmonitored status (I/B-NR)
• CIED evaluation performed immediate pre- and post-MRI and with
standardized protocol (I/B-NR)
Pacing Dependent?
YES NO
• Personnel with skills to perform
ACLS are present during the time
the patient is reprogrammed and
until assessed and declared stable
to return to unmonitored status
(I/B-R)
• Personnel with skill to program the
CIED are available as defined by
institutional policy (I/C-EO)
• Keep external defibrillator and
CIED programmer available outside
of Zone 4 (I/C-EO)
• Personnel with skill to program
CIED available on premises,
physician with ability to direct
CIED programming available
on premises (I/B-NR)
• Program to nonpacing mode
(OVO/ODO) or inhibited
mode (VVI/DDI) with
deactivation of advanced or
adaptive features (IIa/B-NR)
• If CRT device reasonable to
program to asynchronous
pacing with rate to avoid
competitive pacing (IIa/C-EO)
