Atrial Fibrillation (AF)
Conditions
Keywords
Atrial Fibrillation, Cardiology, Emergency Medicine, Myocardial Infarction, Myocardial Ischemia, Coronary Artery Disease
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. 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)
Interventions
DIAGNOSTIC_TESTCT coronary angiography
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)
Sponsors
British Heart Foundation
NHS Lothian
University of Edinburgh
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age 18 years and over 2. Primary presentation with symptoms related to atrial fibrillation 3. Atrial fibrillation with a ventricular rate \>100 bpm on a 12-lead electrocardiogram 4. Able to provide informed consent
Exclusion criteria
1. Previous myocardial infarction 2. Previous coronary revascularisation procedure 3. Patients in renal failure (eGFR \<30ml/min/1.73m2) or major allergy to contrast media 4. Pregnancy or breast feeding 5. Deemed unsuitable for participation in the study by the attending clinician 6. Previous enrolment in the trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of obstructive coronary artery disease | within 4 weeks of presentation | 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Imaging evidence of new myocardial infarction | within 4 weeks of presentation | Imaging evidence of new myocardial infarction |
Countries
United Kingdom
Outcome results
None listed