[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100593131":3},{"organization":4,"armGroups":7,"interventions":20,"overallOfficials":31,"centralContacts":37,"locations":48,"responsibleParty":103,"collaborators":26,"id":105,"slug":106,"hasResults":107,"nctId":108,"briefTitle":109,"officialTitle":109,"acronym":110,"eligibilityCriteria":111,"healthyVolunteers":107,"sex":112,"minAge":113,"maxAge":26,"enrollmentInfo":114,"targetDuration":26,"studyType":117,"phases":118,"briefSummary":120,"conditions":121,"keywords":124,"overallStatus":51,"whyStopped":26,"lastUpdateSubmitDate":128,"lastUpdatePostDateStruct":129,"startDateStruct":132,"completionDateStruct":134,"leadSponsor":136,"locationsCount":137},{"fullName":5,"class":6},"Ottawa Heart Institute Research Corporation","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Standard of Care","ACTIVE_COMPARATOR","Patients in the control arm will be treated according to current standard of care as determined by the primary treating emergency department physician and may vary by institution and physician. Treatment in the standard of care group may include a rate control strategy with or without a planned cardioversion after 3 weeks of anticoagulation, deferring management for outpatient evaluation, request for TEE-facilitated cardioversion in the ED, or specialist consultation for further management or admission to hospital.",[13],"Other: Standard of care management",{"label":15,"type":16,"description":17,"interventionNames":18},"CCT-facilitated cardioversion arm","EXPERIMENTAL","Patients in this arm will undergo cardiac computed tomography angiography (CCT) to evaluate for a left atrial\u002Fleft atrial appendage (LA) thrombus. If the CCT shows no LA thrombus then the emergency department physician will be able to perform electrical and\u002For chemical cardioversion at their discretion. If the CCT shows a LA thrombus then cardioversion will be contraindicated and further management will be at the discretion of the treating physician.",[19],"Diagnostic Test: Cardiac computed tomography angiography",[21,27],{"type":22,"name":23,"description":24,"armGroupLabels":25,"otherNames":26},"DIAGNOSTIC_TEST","Cardiac computed tomography angiography","Patients will undergo CCT according to the following protocol. A non-contrast enhanced prospective ECG-triggered image will be acquired followed by a contrast-enhanced prospective ECG-triggered image using a tri-phasic contrast protocol. Delayed CT images 60 seconds after the initial contrast-enhanced CT scan will be obtained. Cardiac CT image interpretation will be performed according to routine clinical practices in a pragmatic fashion. The LA will be assessed for filling defects and characterized based upon attenuation values. If LA thrombus cannot be excluded, filling defects will be assessed on the delay images. Increases in attenuation would be consistent with pseudo-thrombus from 'slow flow' and 'incomplete opacification'. Areas where attenuation does not change significantly (persistent filling defect) will be diagnosed as thrombus. If the CCT shows no LA thrombus then the ED physician will be able to perform electrical and\u002For chemical cardioversion at their discretion.",[15],null,{"type":6,"name":28,"description":29,"armGroupLabels":30,"otherNames":26},"Standard of care management","Patients in the standard of care arm may undergo any combination of the following management strategies in the emergency department (ED) at the discretion of their treating physician:\n\n1\\. Transesophageal echocardiogram (TEE) facilitated cardioversion; 2. Rate control; 3. Consultation with inpatient cardiac specialist for assessment\u002Fmanagement and consideration of hospital admission; 4. cardioversion after 3 weeks of anticoagulation; and\u002For 5. Outpatient referral to cardiac specialist or general practitioner for further management.",[9],[32,35],{"name":33,"affiliation":5,"role":34},"Benjamin Chow, MD PhD FRCPC FACC FESC FA","PRINCIPAL_INVESTIGATOR",{"name":36,"affiliation":5,"role":34},"Mehrdad Golian, MD MSC FRCPC",[38,44],{"name":39,"role":40,"phone":41,"phoneExt":42,"email":43},"Farrah Ahmed","CONTACT","613-696-7000","12697","fahmed@ottawaheart.ca",{"name":45,"role":40,"phone":41,"phoneExt":46,"email":47},"Yeung Yam","19703","yyam@ottawaheart.ca",[49,68,87],{"facility":50,"status":51,"city":52,"state":53,"zip":54,"country":55,"countryCode":56,"cosmosGeoPoint":57,"geoPoint":62,"contacts":63},"Penn State Health Milton S. Hershey Medical Center","RECRUITING","Hershey","Pennsylvania","17033","United States","US",{"type":58,"coordinates":59},"Point",[60,61],-76.65025,40.28592,{"lat":61,"lon":60},[64],{"name":65,"role":40,"phone":66,"phoneExt":26,"email":67},"Murtaza Akhter, MD","603-418-2868","makhter@pennstatehealth.psu.edu",{"facility":69,"status":51,"city":70,"state":71,"zip":72,"country":73,"countryCode":74,"cosmosGeoPoint":75,"geoPoint":79,"contacts":80},"The Ottawa Hospital Civic Campus","Ottawa","Ontario","K1Y 1J8","Canada","CA",{"type":58,"coordinates":76},[77,78],-75.69812,45.41117,{"lat":78,"lon":77},[81,86],{"name":82,"role":40,"phone":83,"phoneExt":84,"email":85},"Ian Stiell, MD","613-798-5555","18683","istiell@ohri.ca",{"name":82,"role":34,"phone":26,"phoneExt":26,"email":26},{"facility":88,"status":51,"city":89,"state":71,"zip":90,"country":73,"countryCode":74,"cosmosGeoPoint":91,"geoPoint":95,"contacts":96},"Sunnybrook Health Sciences Centre","Toronto","M4N 3M5",{"type":58,"coordinates":92},[93,94],-79.39864,43.70643,{"lat":94,"lon":93},[97,102],{"name":98,"role":40,"phone":99,"phoneExt":100,"email":101},"Idan Roifman, MD","416-480-6100","Ext. 6771","Idan.Roifman@sunnybrook.ca",{"name":98,"role":34,"phone":26,"phoneExt":26,"email":26},{"type":104,"investigatorFullName":26,"investigatorTitle":26,"investigatorAffiliation":26,"oldNameTitle":26,"oldOrganization":26},"SPONSOR","100593131","left-atrial-imaging-prior-to-cardioversion-leveraging-computed-tomography-to-rule-out-thrombus-in-the-emergency-department-la-clotted-100593131",false,"NCT07002450","Left Atrial Imaging Prior to Cardioversion: Leveraging Computed Tomography to Rule Out Thrombus in The Emergency Department (LA CLOTTED)","LA CLOTTED","Inclusion Criteria:\n\n1. Age ≥18 years old; and\n2. Primary symptomatic AF without a reversible underlying cause (e.g. sepsis, pneumonia, pulmonary embolism, hyperthyroidism)\n3. LA imaging required before cardioversion according to local clinical practice guidelines\n\nExclusion Criteria:\n\n1. Patients with an indication for emergency cardioversion (e.g. hemodynamic instability (systolic blood pressure\\\u003C90mmHg or signs of shock), cardiac ischemia (ongoing severe chest pain or marked ST depression on ECG \\>2mm), or pulmonary edema (significant dyspnea, crackles, or hypoxia)); or\n2. Contraindication to CCT (renal insufficiency (eGFR\\\u003C 45ml\u002Fmin\u002F1.73m2), allergy to intravenous contrast agents, pregnancy (contraindications to radiation exposure), or inability to perform 20-second breath-hold)","ALL","18 Years",{"count":115,"type":116},190,"ESTIMATED","INTERVENTIONAL",[119],"NA","The goal of this randomized clinical trial is to learn whether patients with symptomatic atrial fibrillation or atrial flutter (AF) who require heart imaging to rule out a blood clot before cardioversion would benefit from cardiac computed tomography angiography (CCT) in the emergency department (ED) compared to current standard of care management.\n\nThis will be a multicenter trial evaluating whether CCT-facilitated cardioversion in the ED reduces hospital admission, reduces repeat presentations to hospital and improves patient quality of life compared to the current standard of care.\n\nParticipants will undergo CCT-facilitated cardioversion or be treated according to current standard of care while in the ED and complete quality of life questionnaires in the ED and follow-up at 30 days.",[122,123],"Atrial Fibrillation (AF)","Atrial Flutter",[23,125,126,127],"Cardioversion","Atrial flutter","Atrial fibrillation","2026-06-08",{"date":130,"type":131},"2026-06-09","ACTUAL",{"date":133,"type":131},"2025-06-15",{"date":135,"type":116},"2028-06-15",{"name":5,"class":6},3]