Table 2

Summary of roles and responsibilities of each team member regarding MRI scanning of patients with MR Conditional CIEDs

Person	Key roles and responsibilities for MRI with MR Conditional CIEDs
Patient	Ensure that the referrer and MRI departments are aware of presence of CIED prior to attending the scan. Facilitate provision of CIED information to radiology departments prior to scanning.
Cardiologist/Cardiac physiologist	Ensure that MR Conditional CIED systems are implanted wherever possible (including consideration of pre-existing leads during generator exchange). Include discussion regarding MR labelling in formal consent pre-implant (essential for MR Unlabelled CIED or MR Conditional CIED outside specified MR conditions). Patient education postimplant regarding MRI and who to contact if difficulties accessing MRI. Document MR Conditional labelling of the system and each component in medical records and on CIED identification card. Communication with radiology department regarding CIED details, MR labelling and any potential exclusions (eg, abandoned leads), if requested during scan booking. Device interrogation and reprogramming pre-MRI and post-MRI. Rhythm monitoring during scan (dependent on local protocols).
Referrer	Decision to perform and refer for MRI based on the same factors as for patients without CIEDs. Identify the presence of CIED on MR request. Provide clinical indication for the scan to enable appropriate protocol. Liaise with cardiologist and patient to provide CIED details to MRI centre.
MR Clinicians (radiologist/imaging cardiologist)	Establish process for accepting MRI referrals and identifying the appropriate radiologists who will check and report scans. Review referral and prescribe scan protocol within MR conditions. Patient safety during the MR examination. May be required to check completeness of scan information before patient leaves the MR scanner.
MR Responsible Person	Ensure appropriate local MR safety policies are in place. Ensure MR staff have appropriate MR safety training. Advise on the procurement and assessment of MR Conditional monitoring equipment.
MR Safety Expert	Provision of MR safety advice. Advise on MR sequence optimisation to meet scanning conditions and reduce artefact. May assist in MR safety training. Advise on the procurement and assessment of MR Conditional monitoring equipment.
MR Radiographer	Check all local MR safety processes are followed for each patient. Ensure MR conditions are adhered to. Patient safety and communication before, during and after the MR examination. Ensures that the scan is complete and will not require recall, or seeks advice where needed. Rhythm monitoring during scan (dependent on local protocols).

Most units will have several staff members trained to fulfil each of the roles, and there may be overlap in responsibilities.
CIED, cardiac implantable electronic device.