Key result
Presence of a CIED is linked to ~4-fold longer delays to urgent MRI execution.
Why the study?
Despite MRI-conditional manufacturing standards since 2014 and international guidance advocating equitable access, clinicians report substantial delays to urgent MRI for patients with CIEDs, and it was unclear where delays occur in the clinical pathway.
Does the presence of a cardiac implantable electronic device increase delays to request-to-vetting and request-to-scan execution times in patients requiring urgent inpatient and emergency department MRI?
Cohort (n=1,243)
No
Does the presence of a cardiac implantable electronic device increase delays to request-to-vetting and request-to-scan execution times in patients requiring urgent inpatient and emergency department MRI?
Patients with cardiac implantable electronic devices experience a median additional delay of 76.9 hours for urgent MRI scans compared to patients without devices, primarily driven by post-vetting system bottlenecks.
Answers are grounded in this paper and cite their sources.
Urgent MRI access remains inequitable for CIED patients; leaves open whether workflow interventions can mitigate post-vetting delays.
Background There are more than 500,000 people in the UK living with CIEDs1, each with a 75% lifetime chance of needing a magnetic resonance scan2. Simultaneously, magnetic resonance imaging (MRI) has become an essential diagnostic modality in the acute setting for conditions such as stroke, spinal cord compression and cerebral abscess. European manufacturing standards have defined that CIEDs must be produced to be MRI-conditional since 2014. Despite international guidance advocating equitable access, clinicians continue to report substantial delays in practice. Delayed access to MRI can prolong hospital admission, and in time-sensitive situations (such as stroke or spinal cord compression) diagnostic delays may contribute to avoidable increased long-term morbidity. Purpose To determine whether patients with CIEDs experience inequitable delays to access to urgent MRI and identify where delays occur in the pathway. Methods We conducted a two-year retrospective service evaluation of all urgent inpatient and emergency department MRI scans at a large UK tertiary hospital; between June 2023 and June 2025. Two cohorts were analysed: patients with CIEDs and patients without CIEDs. Primary outcomes measured: ‘request to vetting time’ and ‘request to scan execution time’. Groups were statistically compared using the, non-parametric, Mann–Whitney U test. Results 1243 urgent MRI scans were included (136 CIED, 1107 non-CIED). CIED patients experienced significantly longer delays:Median request-to-vetting time: 17.7 (2.0 - 47.4) vs 1.3 (0.3 - 15.3) hours (p<0.0001)Median request-to-scan execution time: 90.4 (46.8 - 138.4) vs 22.5 (5.0 - 45.0) hours (p<0.0001) The data illustrates a median additional delay of 76.9 hours. Post-vetting delays remained 3-fold longer in CIED patients, indicating the dominant bottleneck occurs after safety clearance. These delays frequently exceeded 48 hours. The magnitude of delay is clinically meaningful in the context of time-sensitive neurological and infectious diagnoses. Conclusions Patients with CIEDs experience clinically significant delays, with a median additional wait of nearly four days for urgent MRI. Delays appear driven by system configuration rather than safety clearance, highlighting the need for standardised pathways to ensure equitable access to MRI for patients with CIEDs.
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Dosanj et al. (2026) conducted a cohort in Urgent MRI scan requirement in patients with or without cardiac implantable electronic devices (CIEDs) (n=1,243). Cardiac implantable electronic devices (CIEDs) vs. Patients without CIEDs was evaluated on Request to vetting time and request to scan execution time (hours) (Median difference 76.9 hours, p=<0.0001). Patients with CIEDs experienced longer median delays to urgent MRI execution than those without CIEDs.
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