Millar Lynne Martina, Robinson Andrew George, O'Flaherty Maurice Thomas, Eames Niall, Johnston Nicola, Heyburn Gary
Department of Cardiology, Royal Victoria Hospital, 274 Grosvenor Road, Belfast BT12 6BA, Northern Ireland.
Case Rep Med. 2010;2010:292071. doi: 10.1155/2010/292071. Epub 2011 Feb 6.
Having a pacemaker has been seen an absolute contraindication to having an MRI scan. This has become increasingly difficult in clinical practice as insertion of pacemakers and implantable cardiac defibrillators is at an all time high. Here we outline a case where a 71-year-old male patient with a permanent pacemaker needed to have an MRI scan to ascertain the aetiology of his condition and help guide further management. Given this clinical dilemma, an emergency clinical ethics consultation was arranged. As a result the patient underwent an MRI scan safely under controlled conditions with a consultant cardiologist and radiologist present. The results of the MRI scan were then able to tailor further treatment. This case highlights that in certain conditions an MRI can be performed in patients with permanent pacemakers and outlines the role of clinical ethics committees in complex medical decision making.
装有心脏起搏器一直被视为进行磁共振成像（MRI）扫描的绝对禁忌症。在临床实践中，这一情况变得越来越棘手，因为心脏起搏器和植入式心脏除颤器的植入率正处于历史高位。在此，我们概述一个病例，一名71岁的男性永久性心脏起搏器患者需要进行MRI扫描，以确定其病情的病因并帮助指导进一步的治疗。鉴于这一临床困境，安排了一次紧急临床伦理会诊。结果，在有心脏科顾问医生和放射科医生在场的可控条件下，患者安全地接受了MRI扫描。然后，MRI扫描结果能够为进一步的治疗提供依据。该病例表明，在某些情况下，永久性心脏起搏器患者可以进行MRI扫描，并概述了临床伦理委员会在复杂医疗决策中的作用。
