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Cardiac imaging · United Kingdom

MRI with a pacemaker or ICD, safely, at a specialist centre.

Modern MR‑conditional pacemakers and defibrillators can be scanned routinely. Older legacy devices can be scanned too - under BHRS, RCR and MHRA protocol, with a cardiac physiologist in the room.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a CIED–MRI costs in the UK - private and NHS.

NHS scans are free. Private ranges below cover the scan plus the essential device interrogation on either side.

In short

£400–£800 for the scan, plus £150–£350 for device checks.

Scan or step Indicative range
MRI (MR‑conditional device) 1.5T, single region £450–£850
MRI (MR‑conditional device) 3T, single region £550–£1,000
MRI (legacy MR‑unsafe device) - specialist protocol £900–£1,800
CIED pre‑ and post‑scan interrogation £150–£350
Cardiac physiologist attendance during scan £150–£300
Cardiology review (if device change flagged) £200–£400

Prices vary by centre, by field strength (1.5T vs 3T), and by whether the device is MR‑conditional or a legacy system on a specialist protocol. NHS pathways are unaffected - refer to your usual cardiac centre.

The problem

The historic “no” has been revised - but the pathway matters.

For years a pacemaker or ICD meant no MRI. That is no longer true. Modern devices are designed for it, and legacy devices can be scanned under strict protocol - provided the centre knows what it is doing.

  • MR‑conditional and not sure?

  • Legacy device, need the scan?

    BHRS/HRS consensus supports scanning under protocol at a specialist centre.

  • Cancelled at the door before?

    Unknown device, no card, wrong centre - a fixable problem. We identify the device and route you properly.

The journey

From referral to reprogramming - what happens, in order.

One coordinated pathway between the MRI centre and your cardiac device clinic - before, during and after the scan.

  1. 01

    Before

    A short, confidential form. Which device (make, model, year), what the MRI is for, and whether you are pacemaker‑dependent.

  2. 02

    Before

  3. 03

    Before

    Cardiac device clinic pre‑scan interrogation

    The physiologist interrogates the device: battery, thresholds, lead impedance, pacing dependency - and reprograms for MRI mode.

  4. 04

    On the day

    Arrival at the MRI centre

    A safety questionnaire, ECG electrodes on, pulse oximetry attached, and the physiologist ready in the console room.

  5. 05

    On the day

    The scan itself

    Scan performed inside the specified field strength and SAR limits, with continuous cardiac monitoring throughout.

  6. 06

    On the day

    Immediate post‑scan checks

    Device reinterrogated straight after: reprogrammed back to normal settings, thresholds and impedance rechecked, ICD tachy detection reactivated.

  7. 07

    After

    Report and device follow‑up

    Radiology report to your referrer. A device check at your usual cardiac clinic at the routine interval - earlier if anything changed.

Typical end‑to‑end: 1–2 weeks from referral to scan. Plan for a half‑day at the MRI centre.

When it helps

When MRI is the scan a CIED patient actually needs.

The situations where an MRI answers the question no other imaging can - plus the one scenario that means stop and refer.

  • Suspected stroke or brain lesion

    MRI head is often the only test that will answer the question - and modern pacemakers can be scanned safely.

  • Back or nerve‑root pain

    MRI spine for radiculopathy, cauda equina concern, or before spinal injections - the scan that changes management.

  • Cancer staging or surveillance

    MRI prostate, liver, pelvis or breast where CT will not do - a CIED is no longer an automatic barrier.

  • Joint or soft‑tissue problem

    MRI knee, shoulder or hip - provided the device sits outside the scan zone the manufacturer specifies.

  • Cardiac MRI itself

    For scar burden, myocarditis or cardiomyopathy work‑up - done at a centre familiar with CIED artefact.

  • Legacy device, real clinical need

    An older non‑conditional pacemaker or ICD can still be scanned under a strict protocol when the answer really matters.

  • Abandoned or epicardial leads

    Capped abandoned leads and epicardial systems carry more heating risk - a specialist decision, not a routine refusal.

  • Red flag: pacemaker‑dependent + unknown device

    A pacemaker‑dependent patient with no device card, at a centre without a CIED pathway, should not be scanned that day. Refer on.

Device pathways

One protocol per device category.

What actually happens depends on which category your device falls into - from routine MR‑conditional through to legacy systems with abandoned or epicardial leads.

  • MR‑conditional pacemaker, 1.5T

    The commonest scenario - modern device inside manufacturer conditions, MRI mode enabled, scan proceeds routinely.

  • MR‑conditional pacemaker, 3T

    Newer devices with 3T approval - still requires the exact conditions the manufacturer specifies (field, SAR, exclusion zones).

  • MR‑conditional ICD

    Tachyarrhythmia detection deactivated before the scan to prevent an inappropriate shock, then reactivated straight after.

  • Legacy MR‑unsafe pacemaker

    Non‑conditional device, no manufacturer approval - scan proceeds under BHRS/HRS consensus protocol when clinically necessary.

  • Legacy MR‑unsafe ICD

    Higher risk category - a specialist centre decision with cardiology, radiology and physiologist consensus.

  • Abandoned or capped leads

    A previously extracted lead cut short and capped concentrates heating - a case‑by‑case assessment before scanning.

  • Epicardial lead system

    Leads attached to the outside of the heart - higher heating risk than transvenous systems and rarely scanned outside specialist centres.

  • Cardiac MRI in a CIED patient

    Feasible but expect image artefact near the pulse generator - read by a radiologist who knows the pattern.

Safety and complications

What can go wrong - and how the protocol stops it.

The theoretical risks are lead‑tip heating, threshold or impedance change, an inappropriate ICD shock, and image artefact. Every one has a specific mitigation in the protocol.

  • Modern devices can be scanned

    Around 95% of new UK pacemakers and ICDs implanted since 2015 are MR‑conditional - designed and tested to be scanned under specified conditions.

  • Legacy devices are not an automatic no

    BHRS and international consensus (HRS/EHRA/ESC) support scanning legacy MR‑unsafe devices under strict protocol when the scan is clinically necessary and there is no alternative.

  • ICDs need tachy detection off

    Left on, an ICD can misread MRI noise as a fast arrhythmia and deliver an inappropriate shock. It is deactivated before the scan and reactivated straight after.

  • Pacemaker‑dependent - asynchronous mode

    For patients who cannot rely on their own rhythm, the device is set to asynchronous pacing so the MRI environment cannot inhibit output.

  • Field strength and SAR limits matter

    The manufacturer conditions specify field strength (usually 1.5T, some 3T), maximum SAR, and often an exclusion zone around the device.

  • Continuous monitoring throughout

    ECG electrodes and pulse oximetry stay on for the whole scan, watched from the console room by the cardiac physiologist.

  • Image artefact near the device is normal

    A metallic pulse generator distorts the local image. It rarely affects the answer being asked - but scan planning takes it into account.

  • Full documentation after

    Pre‑ and post‑scan interrogation results, threshold and impedance readings, and the reprogramming back to your usual settings - all recorded.

  • Red flags

    Unknown device, missing implant card, or a centre with no CIED pathway - do not scan that day. Refer to the implanting cardiac centre first.

Reading your report

Your MRI and device report in four parts. Read the last one first.

A CIED–MRI produces two documents - the radiology report and the device interrogation record. Together, they keep to a familiar shape.

A UK consultant cardiologist reviewing an MRI and pacemaker interrogation report

A quiet reminder

Device numbers and MRI language are precise and can read coldly - we translate both for you.

If you would like us to talk you through the report before your cardiology review, just ask.

  1. 01 Header

    Device details and scan indication

    Which pacemaker or ICD you have (make, model, MR status), and the clinical question the MRI was asked to answer.

  2. 02 Technique

    MRI protocol and conditions used

    Field strength (1.5T or 3T), SAR limit, MRI mode used on the device, and whether the region was inside the manufacturer conditions.

  3. 03 Findings

    Radiology findings and any artefact

    The radiological answer to the referral question, and a note on any image artefact from the pulse generator or leads.

  4. 04 Impression

    Device check and next steps

    Read this first: pre‑ and post‑scan device readings, whether anything changed, and when your next device clinic follow‑up should be.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for a CIED–MRI is generally funded when the scan is clinically indicated - the MRI, the device interrogation and the physiologist attendance all count.

Frequently asked

Everything we get asked about MRI with a pacemaker or ICD.

Quick answers on device safety, cost, appointment length, and what happens if your device is legacy or non‑conditional.

  • Can I have an MRI if I have a pacemaker or ICD?

    Usually, yes. Around 95% of pacemakers and ICDs implanted in the UK since 2015 are MR‑conditional - safe to scan inside the manufacturer’s conditions. Older, non‑conditional devices can also be scanned under a strict protocol at a specialist centre when the MRI is clinically necessary and there is no alternative.

  • What does “MR‑conditional” actually mean?

    The manufacturer has tested the device and specified the exact MRI conditions under which it is safe - usually a maximum field strength (1.5T, some newer devices 3T), a maximum SAR, and sometimes an exclusion zone around the pulse generator. Scan inside those conditions and the device is designed to cope.

  • What happens if my pacemaker or ICD is not MR‑conditional?

    It is called “legacy” or MR‑unsafe. UK BHRS 2018 guidance, alongside HRS, EHRA and ESC consensus, supports scanning legacy devices when the answer really matters and there is no alternative test - done at a specialist centre, with device reprogramming, a cardiac physiologist in attendance and full resuscitation cover.

  • How much does an MRI with a pacemaker or ICD cost privately in the UK?

    Roughly £450–£850 for a 1.5T MR‑conditional scan, £550–£1,000 at 3T, and £900–£1,800 for a legacy device on a specialist protocol. Pre‑ and post‑scan CIED interrogation adds £150–£350. NHS scans for CIED patients are free and follow the same protocol.

  • Why does an ICD need to be reprogrammed before an MRI?

    Left in its normal mode, an ICD can misread the electromagnetic noise of the MRI as a dangerous fast rhythm and deliver an inappropriate shock. Tachyarrhythmia detection is turned off for the scan, then turned back on immediately afterwards.

  • Is there any risk of damage to the device?

    The main theoretical risks are lead‑tip heating, changes to pacing thresholds or lead impedance, a transient reset, and rarely a permanent programming change. Scanning inside manufacturer conditions with the correct protocol reduces the risk to a very low level, and the pre‑ and post‑scan checks catch anything that has changed.

  • Will the pacemaker or ICD affect the MRI images?

    The metal pulse generator distorts the local image, and this artefact is unavoidable. It rarely obscures the answer being asked - MRI head, MRI spine and MRI prostate are usually unaffected - but cardiac MRI in a device patient needs a radiologist who knows the pattern.

  • What about abandoned leads or epicardial systems?

    Old leads that have been cut and capped, and leads attached to the outside of the heart (epicardial), carry more heating risk than standard transvenous leads. They do not rule out MRI, but the decision is made case‑by‑case at a specialist centre - not booked as a routine outpatient scan.

  • How long does the whole appointment take?

    Longer than a routine MRI. The device interrogation and reprogramming before the scan takes 30–60 minutes, the MRI itself is the usual 30–45 minutes, and the reinterrogation and reprogramming afterwards takes another 30–60 minutes. Plan for a half‑day.

  • What should I bring to the appointment?

    Your device implant card (or a photograph of it), a list of your current medications, and the referral letter or MRI request form.

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