A Pace Ahead

Pacemaker patients have generally been unable to get an MRI because the magnetic fields can disrupt the device's operation, putting patients at risk for a heart attack. A newly designed pacemaker allows patients to safely receive an MRI.

Medicaid has announced it will add coverage of MRIs for pacemaker patients. The recent decision by the Centers for Medicaid and Medicare Services determined that the addition of coverage could improve health outcomes for cardiovascular patients with a pacemaker.

Ask your doctor if the new pacemaker could benefit you.

The ruling did not include a decision about coverage of the new pacemaker itself, only adding coverage of MRIs for those with the new device. The Revo MRI SureScan Pacing System from Medtronic is the first MR-conditional device available in the United States, having received approval from the U.S. Food and Drug Administration in February. It can cost about $7,000 if purchased out of pocket and requires surgery, but could be worth the cost for patients with serious conditions that benefit from regular MRI scans.

Pacemaker patients are able to have CT scans. MRI scans are more detailed and are often a more accurate diagnostic tool -- but can trigger a heart attack in patients with an older pacemaker.

A pacemaker is a medical device that regulates the heart beat using electrical impulses delivered to the heart muscle by electrodes. It is typically used when the heart beats too slowly or when there is a block in the heart's electrical conduction system.

The new pacemaker has specially insulated wire leads that reduce or eliminate magnetic interference. Before having an MRI, the device can be switched to safe-scanning mode.

Dr. Ron Peshock, a cardiologist and professor of radiology and internal medicine at University of Texas Southwestern Medical Center, said the ability to scan pacemaker patients is a huge benefit because an MRI is the best tool to detect certain conditions. He said a high demand for MRIs likely will help the new pacemakers become the norm and the more conventional devices will be phased out.

Many radiologists still must receive special training to run MRI scans on patients with Revo pacemakers before they become widely available. Very few hospitals are currently conducting such scans on pacemaker patients.