RecruitingNAINTERVENTIONAL

Left Atrial Imaging Prior to Cardioversion: Leveraging Computed Tomography to Rule Out Thrombus in The Emergency Department (LA CLOTTED)

This study, called LA CLOTTED, is looking at a new way to help people who come to the emergency department (ED) with an irregular heartbeat, known as atrial fibrillation or flutter. Sometimes, before fixing the heartbeat, doctors need to check for blood clots in the heart. Usually, this means another type of scan called TEE, which isn't always available quickly in the ED, often leading to a hospital stay. The study is investigating if a quicker heart scan, called Cardiac CT Angiography (CCT), can be used in the ED to check for clots. The aim is to see if using CCT allows people to have their heartbeat fixed sooner, avoids hospital admissions, and improves how they feel overall, compared to the usual care.

At a glance

Status

Recruiting

Phase

Sponsor

Ottawa Heart Institute Research Corporation

Enrolment target

190

Start

15 Jun 2025

Estimated completion

15 Jun 2028

Atrial Fibrillation (AF)Atrial Flutter

What is this study about?

When your heart beats irregularly (a condition called atrial fibrillation or flutter), it can sometimes cause symptoms. Doctors might suggest a procedure to reset your heart's rhythm, which is called cardioversion.

However, if your irregular heartbeat has been going on for a while and you're not already taking blood thinners, there's a small risk of blood clots forming in your heart. If these clots aren't found before cardioversion, they could potentially lead to a stroke. So, it's really important to check for these clots first to make sure the procedure is safe.

The usual way to check for these clots is with a special scan called a transesophageal echocardiogram (TEE). The problem is, this scan isn't always available straight away in every emergency department. This often means people have to be admitted to hospital just to have the scan, or they have to wait for several weeks while taking blood thinners. This study wants to see if a different type of scan, called a Cardiac CT Angiography (CCT), which is more often available quickly in the emergency department, could be a good alternative. The hope is that CCT could help doctors check for clots faster, allow you to have your heart rhythm restored sooner, and potentially avoid an unnecessary hospital stay.

Key takeaways

This study aims to find a quicker way to treat irregular heartbeats in the emergency department.
It compares a special heart scan (CCT) to usual care for checking blood clots.
The goal is to help people get treatment sooner and avoid hospital stays.
It also looks at improving how people feel and their quality of life.
Participation involves a scan and questionnaires, with follow-up after one month.

Who may be eligible?

This study is looking for adults aged 18 or older who have symptoms from an irregular heartbeat (atrial fibrillation or flutter). You would be considered if your doctor believes you need a heart scan to check for blood clots before your heart rhythm can be reset to normal.

However, you wouldn't be able to join if you have other serious medical conditions that might be causing your irregular heartbeat, such as an infection or an overactive thyroid. Also, if you need urgent treatment because your irregular heartbeat is causing severe symptoms like very low blood pressure or serious chest pain, this study wouldn't be suitable for you.

There are also some reasons related to the CCT scan itself that might mean you can't take part. For example, if you have severe kidney problems, are allergic to the special dye used in the scan, are pregnant (as the scan involves X-rays), or can't hold your breath for about 20 seconds during the scan.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Do you have symptoms from an irregular heartbeat (atrial fibrillation or flutter)?
Does your doctor think you need a heart scan to check for blood clots before your heart rhythm is reset?
Do you have any severe kidney problems or allergies to medical dye?
Are you pregnant or unable to hold your breath for about 20 seconds?

Answer every question to see your result.

What does participation involve?

If you join this study, you might have a special heart scan called a Cardiac CT Angiography (CCT) while you are in the emergency department. This scan will check for blood clots in your heart. Depending on the results and if no clots are found, your doctors may then proceed with resetting your heart's rhythm (cardioversion) during the same visit. The other group of participants will receive the usual care for checking for clots and managing their irregular heartbeat, which might involve a different type of scan or medication.

Everyone in the study will fill out questionnaires about their quality of life, both while they are in the emergency department and again after about 30 days. This will help the researchers understand how the different approaches affect how you feel over time. The total time you'd be involved in the study includes your emergency department visit and a follow-up about a month later.

Potential risks and benefits

Taking part in this study might benefit you by potentially allowing your irregular heartbeat to be treated sooner without a hospital stay, which could improve your quality of life. The CCT scan involves a small amount of radiation, similar to other X-ray tests, and an injection of a special dye which can sometimes cause an allergic reaction. You will be carefully monitored for these. You are free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (3)

Penn State Health Milton S. Hershey Medical Center
Verified postcode
Hershey, United States· Recruiting
The Ottawa Hospital Civic Campus
Verified postcode
Ottawa, Canada· Recruiting
Sunnybrook Health Sciences Centre
Verified postcode
Toronto, Canada· Recruiting

Common questions

What is an irregular heartbeat?

It's when your heart beats in an uneven or very fast way, often called atrial fibrillation or flutter. It can make you feel tired, dizzy, or short of breath.

What is cardioversion?

It's a way to gently reset your heart's rhythm back to normal, either using medication or a controlled electric shock.

Why do doctors need to check for blood clots?

If your irregular heartbeat has been going on for a while, small blood clots can form in your heart. Finding and treating these clots before cardioversion is important to prevent a stroke.

What is a CCT scan?

It's a specialized X-ray scan that takes detailed pictures of your heart, helping doctors see if there are any blood clots. It's often quicker to get than other scans in an emergency setting.

Will I get paid for taking part?

The study information does not mention payment for participation. Clinical trials generally do not offer payment for taking part, but may cover travel expenses.

How to find out more

Farrah Ahmed

fahmed@ottawaheart.ca 613-696-7000 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.