[Intl_DxMedPhys] Non-Conditional CIED in MRI

[Tipnis, Sameer]

We have been doing non-conditional implant patients for about 5 years. Our policy includes: (1) Only non-GA patients (2) Having a physicist present in the control room to monitor reduction of Sar / B1+rms (3) Nurse in control room for continuous patient monitoring / and to call code if needed. (4) Device team to come in and program CIED before scan and reset it after scan. Whether to shut pacing off or put the patient on asynchronous pacing mode is the Device team’s decision.

Hope that helps!....
_________________________________________________

Sameer Tipnis, PhD, DABR, FAAPM
Professor of Radiology & Chief, Division of Medical Physics
Program Director, Diagnostic Medical Physics Residency
Dept. of Radiology and Radiological Sciences
Medical University of South Carolina
96 Jonathan Lucas Street, MSC 323
Charleston, SC 29425

Phone: (843)-792-3833
Fax:     (843)-792-2642
_________________________________________________


From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+tipnis=musc.edu at lists.osu.edu> On Behalf Of Gretchen Raterman Bell via Intl_dxmedphys_wd_osu_list
Sent: Tuesday, October 6, 2026 3:47 PM
To: Gretchen Raterman Bell via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: [Intl_DxMedPhys] Non-Conditional CIED in MRI

Good afternoon -- We are reworking our MRI CIED policy at my institution. We have ironed out the conditional CIED section; however, there's much debate about whose presence to require in either Zone III or on the premises for non-conditional

Good afternoon -- We are reworking our MRI CIED policy at my institution.   We have ironed out the conditional CIED section; however, there's much debate about whose presence to require in either Zone III or on the premises for non-conditional
Good afternoon --

We are reworking our MRI CIED policy at my institution.  We have ironed out the conditional CIED section; however, there's much debate about whose presence to require in either Zone III or on the premises for non-conditional CIED scanning. To my knowledge, we have never had an approved MR scan of a patient with a non-conditional CIED.  Therefore, I was curious, for those institutions out there that have had to reference their policy for this scenario, who do you require in the immediate vicinity and who is OK just on the premises?  And do you break your policy down for the non-conditional section into pacing-dependent and not pacing-dependent?

In following the HRS guidelines (and common sense for some of it), we are of course requiring EEG/pulse ox monitoring by a nurse in Zone III, as with conditional CIED patients.  ACLS trained personnel must be in the immediate vicinity/on premises for conditional CIED patients, but should it be a requirement that they are in Zone III for non-conditional?  Just for pacing-dependent patients?  Is the ability to call a code sufficient?  It was brought to our attention that the nurse that accompanies a patient may not always be ACLS trained, just BLS.  And for non-conditional, should all effort be made for the device rep to be there at the time of scanning (interrogations and programming)?  What part does cardiology/device clinic have in all this in an emergency?

I feel like we have been debating this policy for close to a year now, so I wanted to put my feelers out for anyone who is actively doing non-conditional pacemakers.  What works on paper may not work in real life.

Many thank yous in advance,

Gretchen R. Bell, M.S., DABR
Diagnostic Imaging Physicist
Ochsner Medical Center
(504)842-8506
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.osu.edu/pipermail/intl_dxmedphys_wd_osu_list/attachments/20261007/55cb967a/attachment.html>