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

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

1. Age ≥18 years old; and
2. Primary symptomatic AF without a reversible underlying cause (e.g. sepsis, pneumonia, pulmonary embolism, hyperthyroidism)
3. LA imaging required before cardioversion according to local clinical practice guidelines

Exclusion Criteria:

1. Patients with an indication for emergency cardioversion (e.g. hemodynamic instability (systolic blood pressure\<90mmHg or signs of shock), cardiac ischemia (ongoing severe chest pain or marked ST depression on ECG \>2mm), or pulmonary edema (significant dyspnea, crackles, or hypoxia)); or
2. Contraindication to CCT (renal insufficiency (eGFR\< 45ml/min/1.73m2), allergy to intravenous contrast agents, pregnancy (contraindications to radiation exposure), or inability to perform 20-second breath-hold)

About the study

The goal of this randomized clinical trial is to learn whether patients with symptomatic atrial fibrillation or atrial flutter (AF) who require heart imaging to rule out a blood clot before cardioversion would benefit from cardiac computed tomography angiography (CCT) in the emergency department (ED) compared to current standard of care management.

This will be a multicenter trial evaluating whether CCT-facilitated cardioversion in the ED reduces hospital admission, reduces repeat presentations to hospital and improves patient quality of life compared to the current standard of care.

Participants will undergo CCT-facilitated cardioversion or be treated according to current standard of care while in the ED and complete quality of life questionnaires in the ED and follow-up at 30 days.

What is being tested

• Cardiac computed tomography angiography (diagnostic test)
• Standard of care management (other)

Sponsor: Ottawa Heart Institute Research Corporation · Participants: 190 · Started: Jun 15, 2025

Contact the study team

• Farrah Ahmed · Phone: 613-696-7000
• Yeung Yam · Phone: 613-696-7000

Official record on ClinicalTrials.gov — NCT07002450

Locations in the U.S.

Conditions

• Atrial Fibrillation
• Atrial Flutter

From ClinicalTrials.gov, data retrieved Oct 1, 2026. Each study sets its own eligibility; the study team decides who can join.