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

NCT06951100 | Recruiting

• 2 other identifiers: AC2408125-SS-0009
• Study Type: observational
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

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. 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. 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

Conditions

Atrial Fibrillation (AF)

Keywords

Atrial Fibrillation; Cardiology; Emergency Medicine; Myocardial Infarction; Myocardial Ischemia; Coronary Artery Disease

Outcome Measures

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

  within 4 weeks of presentation

Secondary Outcomes (1)

• Imaging evidence of new myocardial infarction

  within 4 weeks of presentation

Interventions

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)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients presenting to an Emergency Department or Acute Medical Unit with rapid atrial fibrillation

You may qualify if:

• 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

You may not qualify if:

• 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
• Deemed unsuitable for participation in the study by the attending clinician
• Previous enrolment in the trial

Sponsors & Collaborators

• University of Edinburgh: lead
• British Heart Foundation: collaborator
• NHS Lothian: collaborator

Study Sites (1)

Royal Infirmary of Edinburgh

Edinburgh, East of England, United Kingdom

RECRUITING

Biospecimen

Retention: SAMPLES WITHOUT DNA

blood samples (plasma and serum)

MeSH Terms

Conditions

Atrial Fibrillation; Myocardial Infarction; Myocardial Ischemia; Coronary Artery Disease

Condition Hierarchy (Ancestors)

Arrhythmias, Cardiac; Heart Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Vascular Diseases; Infarction; Ischemia; Necrosis; Coronary Disease; Arteriosclerosis; Arterial Occlusive Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 28, 2025
• First Posted: April 30, 2025
• Study Start: May 1, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2029
• Last Updated: June 11, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)