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

24. juni 2026 oppdatert av: 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).

Studieoversikt

Detaljert 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.

Studietype

Intervensjonell

Registrering (Antatt)

196

Fase

  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Magnesium Sulfate 2g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Andre navn:
  • Magnesiumsulfat 2 gram/50ml 0,9 % NaCl
Eksperimentell: 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.
Magnesium Sulfate 4g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Andre navn:
  • 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.
The control group will receive a bolus of normal saline of the same volume and infused over 15 minutes.
Andre navn:
  • Kontroll (50 ml 0,9 % NaCl)

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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 administration (IV or PO) for rescue medications (magnesium and metoprolol), if administered.
2 hours from metoprolol administration

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

1. desember 2028

Studiet fullført (Antatt)

1. desember 2028

Datoer for studieregistrering

Først innsendt

21. mai 2026

Først innsendt som oppfylte QC-kriteriene

2. juni 2026

Først lagt ut (Faktiske)

8. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

29. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

24. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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