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New, MRI-friendly pacemaker arrives in Columbia

Friday, February 25, 2011 | 8:37 p.m. CST; updated 10:57 p.m. CST, Monday, February 28, 2011

COLUMBIA — The timing was perfect.

Just when Dave Burle found out he needed a pacemaker, he learned he could get one that would allow him to receive an MRI. This used to be impossible.

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Burle received the first mid-Missouri implantation of this new pacemaker Friday morning at Boone Hospital Center.

Dan Pierce, a cardiologist who has implanted thousands of pacemakers in 19 years at the hospital, implanted the device while Burle remained awake.

Burle did not feel pain, but he felt pushing and pulling inside his chest. The 58-year-old engineer had researched the implantation beforehand and peppered the doctor with questions about the new technology throughout the surgery.

How is the new pacemaker different?

The Revo MRI SureScan, the new pacemaker designed by Medtronic, will make it possible for patients with pacemakers to get magnetic resonance imaging  scans. MRI's are preferred for most injuries, illnesses and neurological disorders.

Before, MRI scans could not be completed on pacemaker patients because the magnetic technology could interrupt pacemaker programming and even heat the leads attached to the heart, cauterizing the muscle.

This danger forced doctors to use CT scans instead on patients with pacemakers. A CT scan involves radiation, not magnetism, and it provides a less detailed image. This makes diagnosis more difficult for certain injuries and illnesses, including tumors, strokes and multiple sclerosis.

"You're probably looking at 15 to 20 percent of the population that we see who cannot get MRI imaging because they have a pacemaker," said Dr. Justin Malone, a neurologist at Boone Hospital Center.

More than half of the people who get pacemakers need an MRI scan later on but can't get one, Pierce said.

The new pacemaker works only with closed MRI scans – the most common – and most patients would be suitable for it.

A Medtronic employee programs the pacemaker before and after an MRI. The programmer uses a small computer held against the patient's chest to adjust the pacemaker, which remains on during the MRI.

What is the cost?

Wendy Dougherty, spokeswoman for Medtronic, wrote in an e-mail that the pacemaker would cost between $5,000 and $10,000 and is covered by Medicare. She said the cost was comparable to other pacemakers.

Medtronic began work on the pacemaker in 1997 and received approval from the Food and Drug Administration in February.

"It's been very well-tested in Europe and in a new test here, and there were no problems," Pierce said.

Burle wasn't worried about being the first. He anticipated the need for an MRI soon because of a shoulder injury.

"These diagnostic tests are just part of life now," Mickey Burle, his wife, said. They come from a sports-playing, outdoors-loving family.

"In one week we had a CT scan and two MRIs," Mickey Burle said, shaking her head. Her son injured himself playing football, and then her husband hurt his foot jumping a fence to go help his son.

One hour after the procedure, Dave Burle smiled. "The joke was, 'I hope it doesn't come with a remote, ’cause she'll kick it up a few notches to get me to do more work around the house.'"

What's next?

This new technology might lead to more.

The pacemaker device assists those with slow heartbeat problems, said Pierce. He hopes the technology will expand to defibrillators, which regulate arrhythmic heartbeat patterns.

"With all the other devices we put in place, we have to tell (patients) that there will never be an MRI," said Pierce.

Malone listed spinal cord stimulators, vagal nerve stimulators and medication pain pumps as other devices that prevent MRIs. "Now that this technology is available, we're going to see it spread rapidly to other implantable devices," he said.


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