Mechanisms of Myocardial Injury and Ischemia in Patients With Rapid Atrial Fibrillation
ConditionAtrial Fibrillation (AF)
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorUniversity of Edinburgh
About this trial
The goal of this observational study is to better understand the role of measuring troponin (a protein measured by a blood test) and coronary imaging in patients presenting with rapid atrial fibrillation (AF)
The main questions this study aims to answer are:
1. Are patients with a fast, irregular heartbeat (rapid AF) and damage to the heart (myocardial injury) more likely than those without damage to the heart to have blocked heart arteries (obstructive coronary artery disease) 2. Are patients with a fast, irregular heartbeat (rapid AF) and damage to the heart (myocardial injury) with further evidence that their heart hasn't been getting enough oxygen (myocardial ischemia) more likely to have imaging evidence of myocardial infarction than those without myocardial ischemia
To do this, we will measure troponin in patients with rapid AF and then carry out further investigations of the heart (electrocardiogram, echocardiogram, CT scan and cardiac MRI)
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age 18 years and over
Primary presentation with symptoms related to atrial fibrillation
Atrial fibrillation with a ventricular rate >100 bpm on a 12-lead electrocardiogram
Able to provide informed consent
Disqualifiers
Previous myocardial infarction
Previous coronary revascularisation procedure
Patients in renal failure (eGFR <30ml/min/1.73m2) or major allergy to contrast media
Pregnancy or breast feeding
Trial population
Patients presenting to an Emergency Department or Acute Medical Unit with rapid atrial fibrillation
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
CT coronary angiography
Diagnostic testTo assess the presence of obstructive coronary artery disease, participants will either have coronary angiography as part of their routine care or they will return for a research CT scan of their heart (CT Coronary Angiogram)
Treatment groups
No treatment groups listed
Trial outcomes
Primary outcomes
1
Presence of obstructive coronary artery disease
Presence of obstructive coronary artery disease as defined as at least one stenosis ≥70% in a major epicardial coronary artery or ≥50% in the left main stem on CTCA or invasive coronary angiography
Time frame
within 4 weeks of presentationSecondary outcomes
1
Imaging evidence of new myocardial infarction
Imaging evidence of new myocardial infarction
Time frame
within 4 weeks of presentationSponsors and contacts
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Source ClinicalTrials.gov