ECHS Order: Unlisted Cardiac Implants – MRI Safe Pacemaker and ICDs

Integrated Headquarters

Ministry of Defence (Army)

Maude Lines

Delhi Cantt-110010

20 Jan 2015

1. Cardiac implant rates were revised by ECHS vide their letter No B/49773/AG/ECHS/Rates/Policy dt 06 Aug 2014. Many empanelled hospitals have now resorted to filling up appx ‘A’ for MRI safe pacemaker and ICDs as unlisted implants at rates many times higher than the listed cardiac implants.

2. Opinion of service cardiologist was sought in this regard which is as under:-

MRI safe cardiac implants specially pacemaker and ICDs have a place in modern cardiology practice, however two facts merit consideration:-

(a) Significant cost difference between conventional system and MRI safe devices.

(b) Globally overwhelming majority of patients are still getting conventional systems and only a small minority, the MRI safe devices. There are proven technical solutions to aquire MRI images in a patient with conventional pacemaker hence the decision to use MRI safe devises must be individualized, keeping in mind the real time requirements of MRI in a given patient, possibility of using other imaging modalities like CT scan and the expected life span of the patient.

3. It is requested that all the concerned authorities in the chain of command and empanelled hospitals be appraised of the judicious use of these unlisted devices.

(Vijay Anand)

Col

Dir (Med)

for MD ECHS