A new survey reveals that communication about the risks of MRI's is inadequate between physicians and older adults with implantable devices.

The survey was conducted by marketing, consultant and research firm, Penn Schoen Berland (PSB; Denver). The firm compiled information through 1,077 online interviews with 652 older adults, 273 caregivers and 152 physicians from Nov. 19-30, 2009.

The survey, which was made possible by a grant from med-tech giant, Medtronic (Minneapolis), found that nearly a third of patients and more than half of caregivers did not recall being informed that they or the person they care for might not be eligible for some forms of medical imaging at the time the device was implanted.

The survey also found that three in 10 electronic implantable device patients have had an MRI despite the risks, and of this group, nearly 20% reported experiencing problems with their device afterwards.

As a result of the findings the National Council on Aging (NCOA; Washington) said that it would host a series of town hall meetings to address the issue.

"Many patients don't know what kinds of imaging tests they have," Harold Litt, MD, Chief of Cardiovascular Imaging at the University of Pennsylvania (Philadelphia) told Medical Device Daily. "I don't think we communicate with patients very well about the safety issues of medical imaging [procedures] that they undergo."

Another problem, according to Litt, is that many patients, who have these implantable devices such as defibrillators are saying that they have had MRI's when in fact another imaging technique has been used.

"Usually physicians suggest other tests because of the complications that can occur from a patient with a pacemaker or heart defibrillator using an MRI. "There are risks," he said. "For example the leads from the generator of the pacemaker could heat up and cause damage to the pacemaker."

The survey also evaluated healthcare provider perceptions and use of guidelines from the American College of Cardiology (ACC; Washington), the American College of Radiology (ACR; Reston, Virginia) and American Heart Association (AHA; Dallas) for MRI use in patients with electronic implantable devices. The physicians reported using clinical guidelines often, referring to the ACC, ACR and AHA guidelines in near equal numbers for medical imaging.

Nearly all healthcare providers surveyed (98%) support more education on medical imaging and electronic implantable devices to help ensure awareness of critical guidelines, including that electronic implantable devices should not be regarded as safe for medical imaging simply because they are labeled as modern or recently manufactured.

"The survey clarifies that older adults with electronic implantable devices such as pacemakers need better information on the benefits and risks of medical imaging," said Stuart Spector, Senior VP of the NCOA. "Our aim is to highlight the results of this survey to increase awareness and facilitate a more productive dialogue between patients, caregivers and healthcare providers."

Medical imaging plays a critical role in early disease detection, diagnosis and treatment. Yet, despite the importance of medical imaging, the NCOA survey found that more than 90% of physicians agreed that MRI is contraindicated and may be risky for patients with certain electronic implantable devices, such as pacemakers, and very few will order MRIs for these patients.

Litt said the key to solving the communications issue is through education and a tighter rapport between healthcare providers and physicians.

"I would hope two things come out of this survey," Litt said. "One would be that physicians that have patients with pacemakers and defibrillators discuss what imaging tests they would have patients undergo. Second I would hope that patients with pacemakers and defibrillators become more aware of the safety issues in undergoing an MRI."

Omar Ford, 404-262-5546;
omar.ford@ahcmedia.com