MUSC leads nation with first use of new MRI-safe defibrillator

When Lucille Robinson woke up in a recovery room at the Medical University of South Carolina, she had a big smile on her face. “The first thing I’m going to do is go to church,” the Beaufort woman said. 

She should be able to that a lot more easily now that she’s become the first person in the country to get a new kind of heart defibrillator. Not only will it do a better job of helping her heart than her old device did, but it also won’t cause problems if she needs a magnetic resonance imaging scan. The cardiac resynchronization therapy defibrillator is called Amplia. 

MUSC cardiologist Michael Gold, M.D., performed the procedure on Robinson. He had good reason to think the implanted CRT defibrillator would work well. “I was the principal investigator of the worldwide trial of the first MRI-safe ICD, which was approved by the Food and Drug Administration last year. The CRT is an extension of the ICD device, so it didn't require any implants before U.S. approval.” His experience made him a natural choice to lead the country in using the new CRT device.

CRT defibrillators are used in people whose hearts are damaged from heart attacks, high blood pressure or other causes. Robinson already had an implantable cardioverter defibrillator, or ICD, a battery-powered device that keeps track of the heart rate and delivers a shock if needed. 

But it wasn’t enough. Robinson’s son said she was so sick that it scared him. His mom, 73, was passing out and had to go to the emergency room several times. She recently had to be given intravenous medicine to remove fluid from her body.

Gold said Robinson needed to be upgraded to the CRT ICD. While an ICD has one or two wires going into the heart, the CRT adds a third to help the two sides of the heart stay in rhythm and pump more efficiently. “A CRT ICD senses the heartbeat and paces both sides of the heart,” Gold said. “When dangerous fast or slow heart rates develop, it can pace or shock the heart to restore normal heart rates.”

Best of all, he said, with the new device, Robinson can safely get MRI scans, which use magnetic fields and radio waves to create images of the inside of the body. Those images give her doctors important information about her condition. “The MRI-safe devices work just like regular devices, but have changes in the device and a special mode to make them safe from the strong magnetic fields of an MRI,” Gold said.

Gold is a national leader in research involving cardiac devices, including the Medtronic Evera MRI SureScan ICD System, which is also MRI-safe. “It is expected that in the future, all devices will be MRI-safe,” Gold said.

The implications are far-reaching. A million people are hospitalized in this country for heart failure every year. Some get CRT defibrillators. Among that group, as many as 40 percent need an MRI within four years. Until now, they haven’t been able to get one.

Gold said this type of research pays off for patients at MUSC. “Having access to cutting-edge therapy is an advantage for our patients. Being involved in new research and helping to develop new treatments is both an opportunity for patients as well as an attraction to bring the best and brightest young doctors to MUSC.”

He said Robinson’s operation went smoothly, and the patient agreed. She was thrilled to be the first in the nation to receive the device. Her family joked that she’s famous now, and her story should be on CNN. 

But Robinson was focused on something else. She thanked the doctor and said she had a message for others in her condition: Have faith. “Watch God. That’s what I want the title of this story to be.”