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Vernakalant for the treatment of new-onset atrial fibrillation 


Journal of Cardiology & Current Research
Jameel Mohsen,1 Elias Hellou,1,2 Ashkar Jalal,c Simcha R. Meisel,1,2 Mark Kazatsker,1 Asaf Danon,1 Margarita Medvedovsky,3 Adham Zidan,1 Majdi Saada,1 Ofer Kobo,1,2 Ariel Roguin,1,2 

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Abstract

Background: Vernakalant is a novel antiarrhythmic agent with preferential effect on atrial myocardial tissue and limited action on ventricular myocardial tissue. Preliminary experience with vernakalant use suggests that conversion to sinus rhythm in patients with recent-onset atrial fibrillation is usually achieved quickly thus allowing early hospital discharge. The current study aimed to evaluate the efficacy of Vernakalant in a busy emergency department.
Methods: Study population included 146 consecutive patients with recent-onset (less than 7 days) atrial fibrillation. Vernakalant was administered as an initial loading dose under continuous blood pressure monitoring. In the absence of conversion to sinus rhythm after 15 minutes, a second dose of the remaining vernakalant dose was administered. The primary endpoint was conversion to sinus rhythm within less than 1 hour.
Results: We studied 146 patients presenting to the emergency department with recent atrial fibrillation. Overall, 114/146 [78%] patients converted to sinus rhythm. Of these, 94 [82.5%] patients converted to sinus after a single dose. The remaining 20 patients converted to sinus rhythm during the second infusion. The median time to conversion after the first dose was 12.5 minutes. The median combined time to conversion (after the first and the second dose) was 21 minutes. All 114 converted patients were discharged with normal sinus rhythm within 3-4 hours after admission.
Conclusion: Current results validate recent publications regarding the efficacy and safety of Vernakalant for the treatment of new-onset atrial fibrillation and support the endorsement of its use by the guidelines.

Keywords

Paroxysmal Atrial Fibrillation, Rhythm Control, Antiarrhythmic drugs, Vernakalant

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