Table 2

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

Key roles and responsibilities for MRI with MR Conditional CIEDs
  • 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).

  • 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.