Atrial Flutter With Rapid Ventricular ResponsePhase 3MAGNETIC-AFNCT07632157
MAGNEsium With meToprolol for Rate Control In Atrial Fibrillation
A Phase 3 study testing Magnesium Sulfate 2g, Magnesium Sulfate 4g and Saline (0.9% NaCl) in people with Atrial Flutter With Rapid Ventricular Response, run by Wake Forest University Health Sciences at 1 site in United States.
Trial summary
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). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Atrial Flutter With Rapid Ventricular Response
- What is being tested?
- Magnesium Sulfate 2g, Magnesium Sulfate 4g and Saline (0.9% NaCl)
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 196 participants
- Where
- 1 siteUnited States
- Study dates
- Oct 2026to Dec 2028
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 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
Who cannot join
- 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
Show all 10Show fewer
- 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
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Thomas Szwajnos contact
United States1 site
Advocate Christ Medical Center Emergency Department (ACMC ED)
Oak Lawn, Illinois, 60453
About this study
Official title: 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).
Read the detailed description
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.
- Being tested
- Magnesium Sulfate 2g, Magnesium Sulfate 4g, Saline (0.9% NaCl)
- Keywords
- AFF RVR, intravenous magnesium, atrial flutter
- Medical subject headings
- Atrial Flutter
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Magnesium Sulfate 2gDrug
Also called Magnesium Sulfate 2 gram/50ml 0.9% NaCl
Magnesium Sulfate 2g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Magnesium Sulfate 4gDrug
Also called Magnesium Sulfate 4 gram/50ml 0.9% NaCl
Magnesium Sulfate 4g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR)
Saline (0.9% NaCl)Drug
Also called Control (50ml 0.9% NaCl)
The control group will receive a bolus of normal saline of the same volume and infused over 15 minutes.
| Study group | Role | What they receive |
|---|---|---|
| Experimental Arm One, Magnesium Sulfate 2g followed by metoprolol 5 mg | Experimental | 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. Receives: Drug: Magnesium Sulfate 2g |
| Experimental Arm Two, Magnesium Sulfate 4g followed by metoprolol | Experimental | 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. Receives: Drug: Magnesium Sulfate 4g |
| Control Arm, normal saline followed by metoprolol | Placebo comparator | 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. Receives: Drug: Saline (0.9% NaCl) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Ventricular rate control
Assessing ventricular rate control within the first 2 hours of intravenous magnesium administration as defined as a ventricular rate of < 120 beats per minute.
Measured: Within the first 2 hours of intravenous magnesium administration
Secondary outcomes (8)
Mean change in heart rate
Mean change in heart rate after the administration of magnesium sulfate
Measured: up to 24 hours after magnesium infusion
Incidence of hypotension
Systolic blood pressure < 90 or MAP < 65
Measured: At 1 and 2 hours after magnesium administration
Incidence of bradycardia
Heart rate < 60 beats per minute
Measured: At 1 and 2 hours after magnesium administration
Mean time to achieve goal heart rate
Mean time to achieve goal heart rate at 2 hours
Measured: at 2 hours
Rate of conversion
Rate of conversion to normal sinus rhythm
Measured: 2 hours after administration of magnesium
Clinical need for rescue medication administration
Dose of rescue medications given (magnesium and metoprolol)
Measured: 2 hours from metoprolol administration
Mean change in heart rhythm
Mean change in heart rhythm after the administration of magnesium sulfate
Measured: up to 24 hours after magnesium infusion
Clinical need for rescue medication administration
Route of administration (IV or PO) for rescue medications (magnesium and metoprolol), if administered.
Measured: 2 hours from metoprolol administration
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jun 2026
- Study startOct 2026 (estimated)
- Primary completionDec 2028 (estimated)
- Study completionDec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Atrial Flutter With Rapid Ventricular ResponseStudies of the same condition, open and under way.
- More trials run by Wake Forest University Health SciencesThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 196 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Wake Forest University Health Sciences
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Marc McDowell, PharmD, Principal investigator, Advocate Christ Medical Center Emergency Department
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07632157
- Sponsor's protocol ID
- IRB00146620
- Acronym
- MAGNETIC-AF
- Status last verified
- Jun 2026
- First submitted
- 21 May 2026
- Last updated
- 29 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- MAGNEsium With meToprolol for Rate Control In Atrial Fibrillation (MAGNETIC-AF)
- ClinicalTrials.gov ID
- NCT07632157
- Acronym / sponsor ID
- MAGNETIC-AF / IRB00146620
- Keywords
- AFF RVR, intravenous magnesium, atrial flutter
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 196 participants (estimated)
- Lead sponsor
- Wake Forest University Health SciencesUniversity, hospital or other
- Study start
- Oct 2026 (estimated)
- Primary completion
- Dec 2028 (estimated)
- Study completion
- Dec 2028 (estimated)
- First posted
- 8 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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).
Detailed description
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Experimental Arm One, Magnesium Sulfate 2g followed by metoprolol 5 mg | Experimental | Drug: Magnesium Sulfate 2gStudy 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. |
| Experimental Arm Two, Magnesium Sulfate 4g followed by metoprolol | Experimental | Drug: Magnesium Sulfate 4gStudy 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. |
| Control Arm, normal saline followed by metoprolol | Placebo comparator | Drug: Saline (0.9% NaCl)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. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- 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
Key exclusion criteria (10 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Magnesium Sulfate 2gAlso: Magnesium Sulfate 2 gram/50ml 0.9% NaClMagnesium Sulfate 2g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR) | Drug | Experimental Arm One, Magnesium Sulfate 2g followed by metoprolol 5 mg |
| Magnesium Sulfate 4gAlso: Magnesium Sulfate 4 gram/50ml 0.9% NaClMagnesium Sulfate 4g for the treatment of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR) | Drug | Experimental Arm Two, Magnesium Sulfate 4g followed by metoprolol |
| Saline (0.9% NaCl)Also: Control (50ml 0.9% NaCl)The control group will receive a bolus of normal saline of the same volume and infused over 15 minutes. | Drug | Control Arm, normal saline followed by metoprolol |
Primary outcome
Ventricular rate control
Time frame: 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.
8 secondary outcomes
Mean change in heart rate
Time frame: up to 24 hours after magnesium infusion
Incidence of hypotension
Time frame: At 1 and 2 hours after magnesium administration
Incidence of bradycardia
Time frame: At 1 and 2 hours after magnesium administration
Mean time to achieve goal heart rate
Time frame: at 2 hours
Rate of conversion
Time frame: 2 hours after administration of magnesium
Clinical need for rescue medication administration
Time frame: 2 hours from metoprolol administration
Mean change in heart rhythm
Time frame: up to 24 hours after magnesium infusion
Clinical need for rescue medication administration
Time frame: 2 hours from metoprolol administration
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jun 2026.
- Individual participant dataSharing planned: No
Related trials for Atrial Flutter With Rapid Ventricular Response
RecruitingPhase 3
Comparing Magnesium 2g Versus 4g Versus Placebo in the Incidence of Treating AFF RVR
Tachycardia Atrial, Atrial Fibrillation
Not yet recruitingPhase 3
Oral Bisoprolol Vs IV Diltiazem in Atrial Fibrillation or Flutter With Rapid Ventricular Rate.
Atrial Fibrillation With Rapid Ventricular Response, Atrial Flutter With Rapid Ventricular Response
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Thomas Szwajnos contact
Marc McDowell, PharmD principal investigator
Advocate Christ Medical Center Emergency Department
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Magnesium Sulfate 2g, Magnesium Sulfate 4g and Saline (0.9% NaCl) in people with Atrial Flutter With Rapid Ventricular Response, run by Wake Forest University Health Sciences at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 29 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Marc McDowell, PharmD ((708) 684-1078, marc.mcdowell@aah.org), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Ventricular rate control (time frame: Within the first 2 hours of intravenous magnesium administration). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2026; AzTrials last refreshed its copy on 7 Nov 2026.