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MAGNEsium With meToprolol for Rate Control In Atrial Fibrillation (MAGNETIC-AF)

2. juni 2026 opdateret af: Wake Forest University Health Sciences

MAGNEsium With meToprolol for Rate Control In Atrial Fibrillation (MAGNETIC-AF)

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).

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Intravenous magnesium has become a commonly utilized agent in the treatment of cardiac arrhythmias as an adjunct therapy to rate and rhythm control medications, such as its use in atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR). Though its benefit in the treatment of AFF RVR has been well documented, a consensus on the optimal dosing of magnesium has yet to be achieved. Only one randomized, controlled, double-blinded study has investigated the optimal dosing of magnesium. The purpose of this prospective, randomized, double-blinded study is to further evaluate the safety and efficacy of varying doses of intravenous magnesium in the treatment of atrial fibrillation or atrial flutter with rapid ventricular response. This study will use flat-dose intravenous metoprolol for rate control to minimize confounders. Additionally, this study will not require a resulted magnesium level prior to treatment in order to avoid delays in patient care.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

196

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Forenede Stater
    • Illinois
      • Oak Lawn, Illinois, Forenede Stater, 60453
        • Advocate Christ Medical Center Emergency Department (ACMC ED)

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • 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

Exclusion Criteria:

  • 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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Experimental Arm One, Magnesium Sulfate 2g followed by metoprolol 5 mg
Study 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.
Medicin: Magnesium Sulfate 2g
Magnesium Sulfate 2g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Andre navne:
  • Magnesiumsulfat 2 gram/50ml 0,9% NaCl
Eksperimentel: Experimental Arm Two, Magnesium Sulfate 4g followed by metoprolol
Study 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.
Medicin: Magnesium Sulfate 4g
Magnesium Sulfate 4g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Andre navne:
  • Magnesium Sulfate 4 gram/50ml 0.9% NaCl
Placebo komparator: Control Arm, normal saline followed by metoprolol
50ml 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.
Medicin: Saline (0.9% NaCl)
The control group will receive a bolus of normal saline of the same volume and infused over 15 minutes.
Andre navne:
  • Kontrol (50 ml 0,9 % NaCl)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Ventricular rate control
Tidsramme: Within the first 2 hours of intravenous magnesium administration
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

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Mean change in heart rate
Tidsramme: up to 24 hours after magnesium infusion
Mean change in heart rate after the administration of magnesium sulfate
up to 24 hours after magnesium infusion
Incidence of hypotension
Tidsramme: At 1 and 2 hours after magnesium administration
Systolic blood pressure < 90 or MAP < 65
At 1 and 2 hours after magnesium administration
Incidence of bradycardia
Tidsramme: At 1 and 2 hours after magnesium administration
Heart rate < 60 beats per minute
At 1 and 2 hours after magnesium administration
Mean time to achieve goal heart rate
Tidsramme: at 2 hours
Mean time to achieve goal heart rate at 2 hours
at 2 hours
Rate of conversion
Tidsramme: 2 hours after administration of magnesium
Rate of conversion to normal sinus rhythm
2 hours after administration of magnesium
Clinical need for rescue medication administration
Tidsramme: 2 hours from metoprolol administration
Dose of rescue medications given (magnesium and metoprolol)
2 hours from metoprolol administration
Mean change in heart rhythm
Tidsramme: up to 24 hours after magnesium infusion
Mean change in heart rhythm after the administration of magnesium sulfate
up to 24 hours after magnesium infusion
Clinical need for rescue medication administration
Tidsramme: 2 hours from metoprolol administration
Route of rescue medications given (magnesium and metoprolol)
2 hours from metoprolol administration

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Wake Forest University Health Sciences

Efterforskere

  • Ledende efterforsker: Marc McDowell, PharmD, Advocate Christ Medical Center Emergency Department

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

1. december 2028

Studieafslutning (Anslået)

1. december 2028

Datoer for studieregistrering

Først indsendt

21. maj 2026

Først indsendt, der opfyldte QC-kriterier

2. juni 2026

Først opslået (Faktiske)

8. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. juni 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • IRB00146620

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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