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

NCT06951100 — Recruiting, 300 participants, University of Edinburgh

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Registry	NCT06951100, acronym Mi-AF
Status	Recruiting
Study type	Observational
Enrollment	300 (Estimated)
Sponsor	University of Edinburgh (Other); collaborators: British Heart Foundation, NHS Lothian
Conditions	Atrial Fibrillation (AF)
Interventions	CT coronary angiography (Diagnostic test)
Dates	start 2025-05-01, primary completion 2026-09-01 (estimated), completion 2029-10-01 (estimated), first posted 2025-04-30, last updated 2026-06-15
Locations	1 site in United Kingdom

-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)

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+Arms and 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)

+Outcome measures

Primary outcomes

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 outcomes

Imaging evidence of new myocardial infarction [within 4 weeks of presentation]: Imaging evidence of new myocardial infarction

+Eligibility

Sex: All, ages: 18 Years to any

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

+Locations (1)

Facility	City	Country	Status
Royal Infirmary of Edinburgh	Edinburgh, East of England	United Kingdom	Recruiting