NWI hospitals implant MRI-friendly heart devices - January 7, 2016

Courtesy of NWI Times

January 07, 2016 9:00 am • Giles Bruce giles.bruce@nwi.com, (219) 853-2584

MERRILLVILLE — Ernest Cook, 36, recently experienced congestive heart failure. Because of his age, his doctors figured he would probably need an MRI at some point in the future.

So they recommended he get a defibrillator that was compatible with magnetic-imaging machines, something that wasn’t previously possible. MRIs can cause the metallic devices to stop functioning properly or altogether.

The Food and Drug Administration recently approved defibrillators that could safely go through MRIs, and Northwest Indiana doctors have followed suit in implanting them in patients. Cook, a stock clerk at a local food bank, had his device put in at Methodist Hospitals.

“An MRI can show things that CAT scans and other tests don’t show,” said Cook’s Merrillville cardiologist, Dr. Harish Shah, who is affiliated with Methodist. “For a young person with 30 to 40 years to go, this leaves that option open.”

Physicians say MRI-compatible defibrillators are currently a little more expensive and less available than the traditional devices, but they are quickly gaining widespread use.

“It should become a standard of care,” said Dr. Sorin Lazar, the Merrillville cardiologist who did Cook’s procedure at Methodist. “I could see using it in every patient from now on.”

Two years ago, Dr. Scott Kaufman, an electrophysiologist at Porter Regional Hospital, participated in a study to determine the efficacy of MRI-compatible defibrillators. He implanted them in about 30 patients, who subsequently underwent MRIs.

“There were no complications,” he said. “As long as you have the right leads and program the device in MRI mode, that essentially turns it off during the MRI scan.”

Kaufman said most of the devices he puts into patients nowadays are MRI-compatible; the only time he might opt against it is if their age makes it unlikely they’ll need another scan. “MRIs are becoming that much more common, for orthopedic issues, even in my specialty, with cardiac MRIs,” he said. “It’s nice to be able to have that safety.”

Kevin Roesch, administrative director of cardiovascular services for Franciscan Alliance’s Northwest Indiana hospitals, which recently started using the devices, noted that Medicare restricts payments for MRIs on patients without compatible defibrillators and that many radiologists won’t even see those people. For all but the very elderly, he noted, there’s really no reason not to use the devices.

“The patients that are in that (younger) age group and where (a defibrillator) is in their best interests are probably the same patients who will have the need for MRI scans,” Roesch said.