Study Evaluating the Use of MRI on CMS Patients

Study Overview
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Brief Summary
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The overall objective of this protocol is to evaluate the safety and utility of diagnostic MRI in Center for Medicare and Medicaid Services (CMS) beneficiaries with pacemakers and Implantable Cardioverter Defibrillators (ICD) and clinical need for MRI.

Detailed Description
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A referring physician will request an outpatient MRI in an implanted device patient through an order placed in the electronic ordering system, over the telephone to the MRI scheduling office, or by directly contacting a radiologist or MRI technologist. Upon receiving such a request, the referring physician will be sent a copy of the attached screening form, which is used for all implanted device patients. The form includes instructions for obtaining approval for the study and space for documenting ordering physician, study indication, and information about the patient's implanted device (if their device is not followed by a UPHS physician). For CMS beneficiaries, an addition to the form will discuss the clinical trial and ask the referring physician how the results of the MRI will change patient treatment or prognosis and what would be done were an MRI not available. The approval of an attending radiologist in the radiology section that will be interpreting the study (e.g. neuroradiology for brain MRI, cardiovascular imaging for cardiac MRI) is required. Once the patient is deemed eligible and consented, the study staff will enter the patient into the registry as well as register them onto the trial through PennChart.

Official Title
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Prospective Observational Study Evaluating the Use of MRI on CMS Beneficiaries With Non-Conditional Pacemakers and/or Implantable Cardioverter Defibrillators

Conditions
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Pacemaker, Implantable Cardioverter Defibrillators

Intervention / Treatment
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* Other: MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients are at least 18 years of age Patients have a medically/clinically indicated need for an MRI as an outpatient Patients with a non-MRI conditional pacemaker and/or ICD implanted after the year 2000 Patients are CMS beneficiaries Patients are willing and able to sign consent and HIPAA authorization or is authorized to sign consent for subject. Exclusion Criteria: Other contraindications to MRI Pacemaker or ICD implanted prior to the year 2000 Patient is unwilling/unable to sign consent and HIPAA authorization Leads and/or generator implanted within 6 weeks of the proposed MRI

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: MRI|MRI|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physician decision making | The primary measure of this study is physician decision making. Referring physicians will be asked about the effect of the MRI clinical management strategy, planning of treatments and interventions, as well as if/how the MRI results prevented other diagnostic studies or interventions, and other exposures (such as to ionizing radiation or iodinated contrast from CT scans). Analysis will be tabulation of how scan would change treatment or prognosis and what would be done if MR not available (based upon referring physician response on the screening form, physician and how the physicians believe that having the MRI will impact the treatment and quality of life by completing the QOL form. | 4 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adverse Events | Adverse events related to the MRI scan will be recorded and reviewed. AE's will be reviewed based on the criteria set forth in the protocol. AEs will be documented on an AE form and AE log and then entered into a redcap database. | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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non-conditional pacemakers, implantable cardioverter defibrillator