Exclusion of Left Atrial Appendage Thrombus in Emergency Department Patients With Atrial Fibrillation Undergoing CT to Assess for Pulmonary Embolus: A Feasibility Study

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorNorthwell Health

About this trial

This study aims to investigate whether a quick, additional CT scan of the heart, performed immediately after a standard CT scan for pulmonary embolism, can effectively detect blood clots in the left atrial appendage (LAA) in patients with atrial fibrillation. Detecting these clots is crucial before certain heart procedures to prevent stroke. Currently, a different, more involved procedure (Transesophageal Echocardiography - TEE) is often used. This study will assess if this additional CT scan is feasible, meaning if it can provide clear enough images to identify LAA clots without needing more contrast dye. The study will involve 60 patients, half receiving an "ungated" CT scan and the other half a "gated" CT scan (timed with their heart rhythm). The results of these scans will not be used for immediate patient care during the study, but rather to evaluate the CT scan technique itself. There is no direct benefit to participants, but the information gained could lead to faster diagnosis and reduced unnecessary testing for future patients.

Eligibility criteria

Qualifiers

Patients above 18 years of age years deemed candidates for CT angiography for pulmonary embolism by the primary team on clinical grounds and noted to be in atrial fibrillation at the time.

Room air oxygen saturation above 92%

Systolic blood pressure above 100 mm Hg

Respiratory rate less than 24 breaths/min

Disqualifiers

Inability to personally give informed consent

Pregnant or breastfeeding individuals

Stroke like symptoms

ECG criteria for ischemia or infarction

Trial design

Treatments tested in this trial

  • Delayed Un-gated CT Scan for Left Atrial Appendage Thrombus
  • Delayed Gated CT Scan for Left Atrial Appendage Thrombus

Treatment groups

60 Participants
are divided into 2 treatment groups

Sponsors and collaborators

Northwell Health

Lead sponsor

Canon Medical Systems, USA

Collaborator