MAGNEsium With meToprolol for Rate Control In Atrial Fibrillation
MAGNETIC-AF
1 other identifier
interventional
196
1 country
1
Brief Summary
The purpose of this research study is to find out if the use of magnesium in addition to Metoprolol, a rate controlling medication that you would be offered in the Emergency Department today unrelated to this study, will help reduce your high heart rate (rapid ventricular response).
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P25-P50 for phase_3
Started Jun 2026
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
May 21, 2026
CompletedStudy Start
First participant enrolled
June 1, 2026
CompletedFirst Posted
Study publicly available on registry
June 8, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 1, 2028
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 1, 2028
June 8, 2026
May 1, 2026
2.5 years
May 21, 2026
June 2, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Ventricular rate control
Assessing ventricular rate control within the first 2 hours of intravenous magnesium administration as defined as a ventricular rate of \< 120 beats per minute.
Within the first 2 hours of intravenous magnesium administration
Secondary Outcomes (8)
Mean change in heart rate
up to 24 hours after magnesium infusion
Incidence of hypotension
At 1 and 2 hours after magnesium administration
Incidence of bradycardia
At 1 and 2 hours after magnesium administration
Mean time to achieve goal heart rate
at 2 hours
Rate of conversion
2 hours after administration of magnesium
- +3 more secondary outcomes
Study Arms (3)
Experimental Arm One, Magnesium Sulfate 2g followed by metoprolol 5 mg
EXPERIMENTALStudy drug (Magnesium Sulfate 2 gram/50ml 0.9% NaCl) will be administered over a time interval of 15 minutes. Immediately after study drug administration, intravenous metoprolol 5 mg will be administered as an IV push over 2 minutes. Additional doses of metoprolol 5 mg as an IV push over 1 minute permissible, however additional doses of study drug will not be administered. Emergency Medicine physician may provide additional doses of intravenous metoprolol every 5 minutes based on clinical necessity.
Experimental Arm Two, Magnesium Sulfate 4g followed by metoprolol
EXPERIMENTALStudy drug (Magnesium Sulfate 4 gram/50ml 0.9% NaCl) will be administered over a time interval of 15 minutes. Immediately after study drug administration, intravenous metoprolol 5 mg will be administered as an IV push over 2 minutes. Additional doses of metoprolol 5 mg as an IV push over 1 minute permissible, however additional doses of study drug will not be administered. Emergency Medicine physician may provide additional doses of intravenous metoprolol every 5 minutes based on clinical necessity.
Control Arm, normal saline followed by metoprolol
PLACEBO COMPARATOR50ml 0.9% NaCl will be administered over a time interval of 15 minutes. Intravenous metoprolol 5 mg will be immediately administered as an IV push over 2 minutes. Additional doses of metoprolol 5 mg as an IV push over 1 minute permissible, however additional doses of saline will not be administered. Emergency Medicine physician may provide additional doses of intravenous metoprolol every 5 minutes based on clinical necessity.
Interventions
Magnesium Sulfate 2g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Magnesium Sulfate 4g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
The control group will receive a bolus of normal saline of the same volume and infused over 15 minutes.
Eligibility Criteria
You may qualify if:
- Age \> 18 years or older
- Able to provide informed consent
- Primary diagnosis atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR) greater than or equal to 120 beats per minute
- Metoprolol as rate control agent
- English speaking
You may not qualify if:
- Hemodynamically unstable patients (SBP \<90, MAP \<65)
- Impaired consciousness
- Acute heart failure exacerbation based on clinical diagnosis, physician exam, bedside echo, and/or additional imaging
- Patient in AFF RVR that is highly suspected to be a compensatory mechanism for an alternative clinical diagnosis
- Rhythms other than atrial fibrillation, such as sick sinus syndrome or wide-complex ventricular response
- Acute myocardial infarction
- Contraindications to magnesium sulfate (including myasthenia gravis)
- Allergy or sensitivity to any study drugs
- Previously enrolled in this trial during a different patient encounter
- Withdrew from study
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Advocate Christ Medical Center Emergency Department (ACMC ED)
Oak Lawn, Illinois, 60453, United States
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Marc McDowell, PharmD
Advocate Christ Medical Center Emergency Department
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, INVESTIGATOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
May 21, 2026
First Posted
June 8, 2026
Study Start
June 1, 2026
Primary Completion (Estimated)
December 1, 2028
Study Completion (Estimated)
December 1, 2028
Last Updated
June 8, 2026
Record last verified: 2026-05
Data Sharing
- IPD Sharing
- Will not share