Miami Cardiac & Vascular Institute eases an anxious patient through cardiac MRI

COVID-19 has impacted millions of people around the world including athletes. Teams have formed “bubbles” to help contain the spread, but even then, dozens of players have become infected. One such patient in the South Florida area was instructed to undergo a cardiac MR following his recovery. “Of the many concerns with COVID-19 patients is that they might develop myocarditis – an inflammation of the heart muscle due to the infection,” says Avila. “So for him to get clearance to return to play, his team required a cardiac MR.” A physician referral brought him to MCVI and cardiac imaging specialist Carlos Avila.

Ambient Experience is an approach to clinical environment design aimed at improving the patient and staff experience. Based on years of design research and collaboration, Ambient Experience integrates dynamic lighting, video and audio components to create positive and engaging environments, with over 3000 installations around the world.

Carlos Avila can attest to the efficacy of Ambient Experience in the MR environment, “We used to have one or two patients a week who would quit due to claustrophobia. Now with Ambient Experience, nearly every single patient goes through without issue. In the nearly two years we’ve been using it, I can count on one hand the number of patients who’ve quit on us.”

The MR Ambient Experience room at MCVI includes the latest in both patient-centric imaging and clinical environmental design to lower stress and increase comfort.

The Ingenia Ambition 1.5T delivers superb image quality even for challenging patients and performs MRI exams up to 50% faster1 with Compressed SENSE accelerations for all anatomies, in both 2D- and 3D scanning.

Compressed SENSE helps patients reduce breath hold time to 3 to 4 seconds in cardiac cine scans. And fast overall exam time is achieved by simplifying patient handling at the bore with touchless guided patient setup.

MCVI has added a complete Ambient Experience consisting of dynamic ambient room lighting, a wall-mounted display screen for video presentations and the Philips In-bore Connect solution which includes a mirror placed directly in the patient’s line of sight and headphones for audio. When a video is selected and played on the display screen, the patient in the bore can watch and hear. From the moment a patient is moved into the scanner (the point at which people report the most stress), through completion of the scan, the In-bore Connect solution can help patients to relax, follow directions and minimize motion.

Carlos Avila describes a typical scenario, “Some patients say, ‘no I’m claustrophobic, it’s going to be impossible for me to go through with this’ and I tell them look, all I ask is that you give me an opportunity and I can assure you you’re gonna be just fine – and of course they are. One thing that I do is I go around to the back, and I have them see me through the mirror and I give them the thumbs up and we proceed without issue.”

Following his recovery from COVID-19, a negative cardiac MR scan was required for our patient’s return to play. His only prior experience with MRI was in a “feet-first” position for imaging of his lower extremities and he was anxious about entering the bore headfirst.

Carlos Avila carefully explained the Ambient Experience options, showing him how he could choose from several calming and engaging themes including a sun-swept beach, a riverboat ride or a lush green forest, accompanied by a soothing soundtrack. He described the mirror and headphone setup and told the patient he would coach him through the entire process.

At first, the patient opted to use only the headphones for music – no mirror or video. It didn’t work, and he had to be pulled out of the bore. As Avila recalls, “I said to him, just give me the opportunity to put the mirror on – with the mirror you’re going to be able to watch a movie and you’re going to be able to see the opening into the room. He said yes, so I positioned the mirror, I put on the movie, and thanks to that he was able to complete the exam successfully.”

“He told me when I got him up after the exam, that if it hadn’t been for that mirror and movie there was no way he would have been able to go through with it. He said, ‘I was ready to quit on you.’” The Ingenia Ambition itself added to the patient’s ability to complete the scan. At 6’ 7” and more than 300 lbs., this athlete was a big man. The Ambition’s big 70cm bore opening and the sturdy ComfortMattress tabletop further enhanced the patient’s experience. “For wider, bigger patients like this guy, the 70cm bore gives them an extra bit of room inside the magnet,” says Avila. Having that extra room – it’s about two inches all around – allows us to comfortably image larger patients. He could not have been imaged in a smaller machine.”

Innovative features of the In-bore Connect solution provide information and guidance to the patient during scanning.

The Ingenia Ambition 1.5T combined with the Ambient Experience not only offers MCVI patients an entirely new exam experience, it improves staff satisfaction. “Our workflow has definitely improved,” says Avila. “What used to happen with many claustrophobic patients is that they’d say, ‘pull me out’ – and so we would. Then we’d have to pull all the coils off and talk them into trying it again. Having Ambient Experience has definitely impacted our procedural efficiency. Our exam times are significantly shorter, and retakes much fewer.” Avila concludes, “The ambient lighting, the wide bore diameter, the ComfortMattress, the TV monitor in the back offering video and information during the scan, and the audio accompaniment – all of it has made a big difference for our patients.”