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The aim of this study was to assess safety and efficacy of SJM MRI conditional pacing system. The study hypothesized that cardiac MRI scan would not affect performance of SJM MRI conditional pacing system.
Accent Cardiac MRI study was a prospective, randomized ,multi-center study conducted in Asia. Subjects indicated for dual-chamber pacemaker and who signed study consent form were considered enrolled and post implant were randomized to either Cardiac MRI Scan Group or Control Group.
Clinical evaluation and device interrogation were performed at baseline, pre- and post-MRI scan, and one month post-MRI for all subjects. At 9-12 weeks post-implant, patients in Cardiac MRI Scan Group underwent an elective non-diagnostic cardiac MRI scan at 1.5 Tesla (T) while patients in Control group underwent device interrogation and clinical evaluation twice with a 45-minute waiting period in between. The safety endpoint was freedom from MRI-related complications while efficacy endpoint was change in right atrial/ ventricular (RA/RV) capture threshold and sensing amplitude from pre-MRI scan to one month post-MRI scan.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cardiac MRI Scan Group | Experimental |
| |
| Control Group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Non-Diagnostic Cardiac MRI scan | Diagnostic Test |
|
| Measure | Description | Time Frame |
|---|---|---|
| Freedom From MRI Scan-related Complications | Number of subjects who were free from MRI scan-related complications | MRI Visit ,1 Month Post MRI Visit |
| Change in Right Atrial (RA) Capture Threshold @0.5 Millisecond (ms) From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced an increase in RA capture threshold @ 0.5 ms at 1-Month post MRI scan visit ≤ 0.5 Volt (V) compared to pre-MRI scan value collected at MRI scan visit | MRI Visit ,1 Month Post MRI Visit |
| Change in Right Ventricular (RV) Capture Threshold @0.5ms From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced an increase in RV capture threshold @ 0.5 ms at 1-Month post MRI scan visit ≤ 0.5 V compared to pre-MRI scan value collected at MRI scan visit | MRI Visit, 1 Month Post MRI Visit |
| Change in RA Sensing Amplitude From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced a decrease in RA sensing amplitude ≤ 50% and at least 1.5 mV at 1-Month post MRI scan visit compared to pre-MRI scan value collected at MRI scan visit | MRI Visit, 1 Month Post MRI Visit |
| Change in RV Sensing Amplitude From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced a decrease in RV sensing amplitude ≤ 50% and at least 5 mV at 1-Month post MRI scan visit compared to pre-MRI scan value collected at MRI scan visit | MRI Visit, 1 Month Post MRI Visit |
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Inclusion Criteria
Exclusion Criteria
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| Name | Affiliation | Role |
|---|---|---|
| Chi Keong Ching, Dr | National Heart Center Singapore | Principal Investigator |
| Rabindra Nath Chakraborty, Dr | Apollo Gleneagles Hospital Kolkata India | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Zhejiang Greentown Cardiovascular Disease Hospital | Hangzhou | China | ||||
| Prince of Wales Hospital |
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| ID | Title | Description |
|---|---|---|
| FG000 | Cardiac MRI Scan Group | Non-diagnostic cardiac MRI scan |
| FG001 | Control Group | No non-diagnostic cardiac MRI scan |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Cardiac MRI Scan Group | Non-diagnostic cardiac MRI scan |
| BG001 | Control Group | No non-diagnostic cardiac MRI scan |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Freedom From MRI Scan-related Complications | Number of subjects who were free from MRI scan-related complications | All subjects in Cardiac MRI Scan group who underwent an elective non-diagnostic cardiac MRI scan and completed all protocol specific visits were included in the analysis. Subjects who withdrew from the study before 1 month post MRI visit and had no MRI scan related complications were excluded. | Posted | Count of Participants | Participants | MRI Visit ,1 Month Post MRI Visit |
|
|
Death, Adverse Device Effect (ADE) and Serious Adverse Device Effect (SADE) from Baseline to 1 month post MRI Scan Visit were collected.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cardiac MRI Scan Group | Non-diagnostic cardiac MRI scan | 4 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute Non-St Elevation Myocardial Infarction | Cardiac disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| New Onset Paroxysmal Atrial Fibrillation | Cardiac disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Project Leader Asia | Abbott (formerly St. Jude Medical) | 0085229967605 | lyim@sjm.com |
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| ID | Term |
|---|---|
| D001919 | Bradycardia |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
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Participants are assigned to one of two groups in parallel for the duration of the study
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| Hong Kong |
| Hong Kong |
| Fortis Hospital | Mohali | Punjab | India |
| Care Institute of Medical Sciences | Ahmedabad | India |
| Apollo Hospitals, Bhubaneshwar | Bhubaneswar | India |
| Medanta - The Medicity Hospital | Gurgaon | India |
| All India Institute of Medical Sciences, New Delhi | New Delhi | India |
| Fortis Escorts Heart Institute and Research Center | New Delhi | India |
| Fortis Flt. Lt. Rajan Dhall Hospital | New Delhi | India |
| Serdang Hospital | Kajang | Malaysia |
| King Chulalongkorn Memorial Hospital | Bangkok | Thailand |
| Ramathibodi Hospital | Bangkok | Thailand |
| Siriraj Hospital | Bangkok | Thailand |
| Withdrawal by Subject |
|
| Patient not confirmed as MRI compatible |
|
| Cardiac Resynchronization Therapy |
|
| BG002 |
| Total |
Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Cardiomyopathy History | Count of Participants | Participants |
|
| Arrhythmia History | Count of Participants | Participants |
|
| Cardiovascular Medication | Count of Participants | Participants |
|
| Participants |
|
|
|
| Primary | Change in Right Atrial (RA) Capture Threshold @0.5 Millisecond (ms) From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced an increase in RA capture threshold @ 0.5 ms at 1-Month post MRI scan visit ≤ 0.5 Volt (V) compared to pre-MRI scan value collected at MRI scan visit | Subject successfully implanted, randomized, completed MRI and 1-month post MRI visit, had pre-MRI sensing amplitude ≥ 5 millivolt (mV) in RV &1.5 mV in RA and had an intrinsic rate ≥ 30 beat per minute (bpm) at the time of ventricular sensing amplitude measurement, received an MRI scan if he was in MRI scan group and fulfilled MRI Conditions of Use | Posted | Count of Participants | Participants | MRI Visit ,1 Month Post MRI Visit |
|
|
|
|
| Primary | Change in Right Ventricular (RV) Capture Threshold @0.5ms From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced an increase in RV capture threshold @ 0.5 ms at 1-Month post MRI scan visit ≤ 0.5 V compared to pre-MRI scan value collected at MRI scan visit | Subject successfully implanted, randomized, completed MRI and 1-month post MRI visit, had pre-MRI sensing amplitude ≥ 5 millivolt (mV) in RV &1.5 mV in RA and had an intrinsic rate ≥ 30 beat per minute (bpm) at the time of ventricular sensing amplitude measurement, received an MRI scan if he was in MRI scan group and fulfilled MRI Conditions of Use | Posted | Count of Participants | Participants | MRI Visit, 1 Month Post MRI Visit |
|
|
|
|
| Primary | Change in RA Sensing Amplitude From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced a decrease in RA sensing amplitude ≤ 50% and at least 1.5 mV at 1-Month post MRI scan visit compared to pre-MRI scan value collected at MRI scan visit | Subject successfully implanted, randomized, completed MRI and 1-month post MRI visit, had pre-MRI sensing amplitude ≥ 5 millivolt (mV) in RV &1.5 mV in RA and had an intrinsic rate ≥ 30 beat per minute (bpm) at the time of ventricular sensing amplitude measurement, received an MRI scan if he was in MRI scan group and fulfilled MRI Conditions of Use | Posted | Count of Participants | Participants | MRI Visit, 1 Month Post MRI Visit |
|
|
|
|
| Primary | Change in RV Sensing Amplitude From Pre-MRI Scan to 1 Month After MRI Scan | Number of subjects who experienced a decrease in RV sensing amplitude ≤ 50% and at least 5 mV at 1-Month post MRI scan visit compared to pre-MRI scan value collected at MRI scan visit | Subject successfully implanted, randomized, completed MRI and 1-month post MRI visit, had pre-MRI sensing amplitude ≥ 5 millivolt (mV) in RV &1.5 mV in RA and had an intrinsic rate ≥ 30 beat per minute (bpm) at the time of ventricular sensing amplitude measurement, received an MRI scan if he was in MRI scan group and fulfilled MRI Conditions of Use | Posted | Count of Participants | Participants | MRI Visit, 1 Month Post MRI Visit |
|
|
|
|
| 140 |
| 6 |
| 140 |
| 1 |
| 140 |
| EG001 | Control Group | No non-diagnostic cardiac MRI scan | 0 | 143 | 6 | 143 | 1 | 143 |
| Anaphylaxis, Anaphylactoid | General disorders | Systematic Assessment |
|
| Cardiac Tamponade | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Dressler's Syndrome | Cardiac disorders | Systematic Assessment |
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| Drug Allergy | General disorders | Systematic Assessment |
|
| Intracranial Hemorrhage | Vascular disorders | Systematic Assessment |
|
| Pericardial Effusion | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Righ Atrial Lead Dislodgement | Cardiac disorders | Systematic Assessment |
|
| Right Ventricular Lead Dislodgement | Cardiac disorders | Systematic Assessment |
|
| System Infection | Infections and infestations | Systematic Assessment |
|
| Ventricular Tachycardia Requiring Emergent Direct Current Cardioversion | Cardiac disorders | Systematic Assessment |
|
| Retracted Right Atrial Lead | General disorders | Systematic Assessment |
|
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| D013568 |
| Pathological Conditions, Signs and Symptoms |
The 2-sided 90% CI for difference in success rate between 2 groups was calculated by Farrington-Manning method. |
The 2-sided 90% CI for difference in success rate between 2 groups was calculated by Farrington-Manning method. |
The 2-sided 90% CI for difference in success rate between 2 groups was calculated by Farrington-Manning method. |
The 2-sided 90% CI for difference in success rate between 2 groups was calculated by Farrington-Manning method. |