Mechanisms of Myocardial Injury and Ischemia in Patients With Rapid Atrial Fibrillation

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 volunteers

Qualifiers

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 test

    To 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 presentation

Secondary outcomes

1

Imaging evidence of new myocardial infarction

Imaging evidence of new myocardial infarction

Time frame
within 4 weeks of presentation

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

University of Edinburgh

Lead sponsor

British Heart Foundation

Collaborator

NHS Lothian

Collaborator