Evaluation of the Safety of MRI Scanning of Patients with MR Conditional Pacemakers

• Main Author: McGurk, Shelly Lynn
• Format: Others
• Language: en
• Published: ScholarWorks 2017
• Subjects: MRI; Pacemaker; Nursing
• Online Access: https://scholarworks.waldenu.edu/dissertations/4009; https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=5112&context=dissertations

Magnetic resonance imaging (MRI) of patients with cardiac implantable electronic devices (CIED) has been associated with risks such as device/lead movement, device dysfunction, and lead heating. New technological advancements have made it possible for MRI to be safely performed when adhering to an evidence-based protocol; however, this practice has not yet been widely adopted. The purpose of this practice-focused question project was to examine the safety of MRI as a diagnostic modality for the aggregate population of adult patients with MR conditional pacemakers when a nurse-practitioner-led, evidence-based protocol was used. The Iowa model served as the guide for implementation of the program, and the Donabedian framework was used to evaluate the program through process, structure, and outcomes. Evidence was obtained through a documentation template that served as the procedural record in the electronic health record. Demographic information, program fidelity, and manufacturer adherence were analyzed through descriptive statistics. Clinical outcomes related to device function were measured pre- and post- MRI and analyzed with chi square and paired t-test inferential statistics to determine if statistically significant change occurs in the setting of MRI scanning. According to data analysis of 34 studies, there were no statistically significant changes in lead impedance, pacing thresholds, or patient reported symptoms pre- and post- MRI. The pilot program has been recommended for organizational adoption and will increase the scope of advanced practice nurses within the organization and provide the CIED aggregate population with access to an important diagnostic modality.