Innovative care to help make patients safer

Norton Healthcare is one of the first hospital systems in the country to manage patients’ cardiac devices remotely.

When Arnold Belker, M.D., went for a magnetic resonance imaging (MRI) scan at Norton Brownsboro Hospital recently, he became a medical pioneer of sorts.

His cardiac device had to be programmed into an MRI-safe mode before he went into the MRI tube, but rather than do it in person and add a possible risk of exposure to the coronavirus, a device manufacturer representative programmed the  device remotely.

Norton Healthcare became one of the first health care organizations in the country to utilize remote device programming to minimize patient exposure.

“If you didn’t tell the patient it was being done remotely, they wouldn’t know the difference,”  said Dr. Belker, 86 and a retired Louisville urologist.

Because MRIs rely on powerful magnets and radio waves to create detailed pictures of organs and tissues in the body, cardiac devices need to be put in a safe mode during the imaging.

“It was no different than ordinarily, except the (device representative) was sitting 20 feet away. He could have been in another building, and it wouldn’t have been any different,” Dr. Belker said.

Keeping the device representative in a different room not only was a good precaution, but also conserved the use of personal protective equipment, which was in short supply nationally at the time.

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According to Dr. Belker, remote programming of the device would make it easier for patients with pacemakers and defibrillators to be scheduled on any day of the week rather than only when the technician can be present.

The ability to reprogram devices isn’t particularly new, but there hadn’t been a need for remote control until the coronavirus pandemic happened. Controlling the cardiac device remotely is somewhat like a computer help desk taking control of your computer temporarily to fix a problem.

In the past, patients with pacemakers or defibrillators were excluded from having an MRI because of concerns the powerful magnets and radiofrequency might harm or in some way disrupt the device, possibly triggering a rapid heart rate.

Cardiac devices have been redesigned so they are safe for MRIs. Now, prior to an MRI, patients simply have their devices reprogrammed to an MRI-safe mode before entering the MRI room.

After the imaging procedure, a technician restores the device’s normal settings.

An estimated 12% to 16% of people with implanted cardiac devices will need an MRI at some point during the year.

Norton Heart & Vascular Institute physicians use devices like the one in Dr. Belker to send information like heart rate and blood pressure to providers. Readings that are outside the normal range result in an immediate call to adjust medications or diet, or make other changes.

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