Can I have an MRI with a pacemaker, ICD or stent? 

Yes, it is possible to have an MRI scan if you have a pacemaker, ICD, or stent, but it requires careful clinical coordination. In the past, cardiac devices were a complete contraindication for MRI due to the powerful magnetic fields involved. However, modern medical engineering has led to the development of MRI conditional devices and stents that are safe for use within the magnetic resonance environment under specific conditions. 

In this article, you will learn about the difference between older and newer devices, the safety of coronary stents, and the rigorous clinical protocols UK hospitals follow to ensure your safety during an MRI. We will also discuss what happens to your device settings during the scan and why clear communication with your radiology team is essential. 

What We’ll Discuss in This Article 

• The definition of MRI conditional versus MRI safe devices. 

• Why coronary stents are generally considered safe for MRI. 

• The role of the cardiac physiologist in preparing your pacemaker or ICD. 

• Risks associated with older, non-pacing systems. 

• UK clinical protocols for scanning heart patients. 

• What to expect before, during, and after your MRI appointment. 

• How to verify the compatibility of your specific implant. 

Safety of coronary stents in an MRI 

If you have a coronary stent, you can almost always have an MRI scan safely. Most modern stents are made from non-ferromagnetic materials, such as stainless steel or cobalt chromium, which do not react strongly to magnets. Once a stent has been in place for more than a few weeks, it is securely embedded into the artery wall, meaning there is no risk of it moving or dislodging during the scan. 

In the UK, clinical guidelines generally state that stents are safe for MRI immediately after implantation, although some centers prefer to wait six weeks for the vessel to heal completely. Unlike pacemakers, stents have no electronic components that can be disrupted, so no special programming or monitoring is required for the stent itself during the imaging process. 

• Most stents are made of non magnetic metals like cobalt chromium. 

• There is no clinical risk of the stent moving or heating up. 

• You do not need special device programming for a stent. 

• Always inform the radiographer about the date and location of your stent. 

MRI conditional pacemakers and ICDs 

If you have a pacemaker or an ICD, the situation is more complex. Most devices implanted in the UK over the last decade are labeled as MRI conditional. This means they are safe to be scanned provided specific clinical criteria are met, such as the type of scanner used and the programming of the device. Older devices are not MRI compatible and can pose significant risks, including lead heating or unpredictable heart pacing. 

Before your scan, a cardiac physiologist will check your device model and the leads connected to it. If the entire system is confirmed as MRI conditional, they will place the device into a specialized MRI Mode. This mode simplifies the pacing and turns off the shock function of an ICD for the duration of the scan to prevent any interference from the magnetic field. 

• MRI conditional means the device is safe under specific settings. 

• Older devices (pre 2010) are often not compatible with MRI. 

• The leads must also be compatible for the whole system to be safe. 

• A cardiac physiologist must be involved in the scanning process. 

The clinical protocol for the scan 

UK hospitals follow a very strict protocol when an MRI is required for a patient with a cardiac device. The radiology department works in tandem with the cardiology team. On the day of the scan, your device will be checked immediately before you enter the MRI room. The physiologist will program it into a safe mode and monitor your heart rhythm throughout the procedure. 

As soon as the scan is finished, the device is checked again and returned to its original, personalized settings. This ensures that any temporary changes made for the magnet are reversed and that the device is functioning perfectly before you leave the hospital. This multi step process is designed to eliminate the risk of the magnet accidentally triggering or disabling your device. 

• Pre scan check: Verifying battery life and lead integrity. 

• MRI Mode activation: Disabling sensors that could be confused by the magnet. 

• Continuous monitoring: Watching your heart rate during the imaging. 

• Post scan check: Reconfirming the device is back to its normal settings. 

What if I have an older, non compatible device? 

If you have an older pacing system that is not MRI conditional, an MRI is usually avoided. In these cases, the clinical team will look for alternative imaging methods that do not use magnets, such as a CT scan or an ultrasound. These alternatives often provide the necessary information without the risks associated with putting an older device in a powerful magnetic field. 

In rare, life threatening situations where an MRI is the only way to get vital information, it can sometimes be performed with extreme caution in specialized centers. However, this is not standard practice and involves a very high level of clinical risk assessment. For the vast majority of patients with older devices, the safety of the patient is the priority, and non magnetic alternatives are chosen. 

• CT scans and ultrasounds are the primary alternatives. 

• Non compatible devices can suffer from internal circuit damage in an MRI. 

• Older leads can act as antennas, potentially heating up the heart tissue. 

• Your cardiologist will decide the safest imaging path for your condition. 

Essential documents and verification 

To have a safe MRI, the radiology team must know exactly what is inside your body. This is why carrying your Medical Device ID Card is vital. This card lists the manufacturer and model number of your pacemaker, ICD, or stent. Without this information, the hospital may be unable to verify the safety of the device, which can lead to your scan being delayed or cancelled. 

If you have lost your card, you should contact the pacing clinic at the hospital where the device was fitted. They can provide you with a copy of your records or a letter confirming the MRI status of your implant. Being proactive and ensuring the radiology department has these details well in advance of your appointment will ensure a smooth and safe experience. 

• The device ID card is the fastest way to verify MRI compatibility. 

• Model numbers of the pulse generator and the leads are both required. 

• Stent information can usually be found in your surgical discharge summary. 

• Verification must happen before you arrive at the MRI suite. 

Differentiation: MRI vs CT scan for heart patients 

It is helpful to distinguish between an MRI and a CT scan, as patients often confuse the two. A CT scan uses X rays and is completely safe for all pacemakers, ICDs, and stents without any special programming. It does not use magnets, so there is no risk of interference. 

An MRI uses powerful magnets and radio waves to create detailed images of soft tissues. Because the magnetic field is always on, even when the machine isn’t clicking, it is the MRI that requires the specialized precautions. If your doctor tells you that you need a scan, always clarify whether it is a CT or an MRI so you can prepare the necessary medical documentation. 

Conclusion 

Having an MRI with a pacemaker, ICD, or stent is safe for most modern patients in the UK, provided the clinical team follows the established safety protocols. Stents are generally not a concern, while pacemakers and ICDs require verification and specialized programming by a cardiac physiologist. By carrying your device ID card and communicating with your medical team, you can access the diagnostic imaging you need while keeping your heart device protected. 

If you have any concerns about your device during an MRI, such as feeling unusual thumping or heat near the implant, alert the radiographer immediately using the emergency call button. 

Authority Snapshot 

This article was written by Dr. Rebecca Fernandez, a UK trained physician with an MBBS and experience in cardiology, general surgery, and intensive care. Dr. Fernandez has managed patients with complex medical implants through both elective and emergency imaging pathways within the NHS. This guide is based on current clinical standards from the British Heart Foundation, NICE, and the Royal College of Radiologists.