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. 2019 Jul 11:24:100398.
doi: 10.1016/j.ijcha.2019.100398. eCollection 2019 Sep.

Vernakalant and electrical cardioversion for AF - Safe and effective

Alexander Simon  1 , Jan Niederdoeckl  1 , Karin Janata  1 , Alexander Oskar Spiel  1 , Nikola Schuetz  1 , Sebastian Schnaubelt  1 , Harald Herkner  1 , Filippo Cacioppo  1 , Anton Norbert Laggner  1 , Hans Domanovits  1
Affiliations

Vernakalant and electrical cardioversion for AF - Safe and effective

Alexander Simon et al. Int J Cardiol Heart Vasc. .

Erratum in

Abstract

Aims: Rapid restoration of sinus rhythm is an integral part of the management of recent-onset atrial fibrillation. We aimed to assess safety and efficacy of vernakalant, a multi-channel blocking agent, in combination with external electrical cardioversion.

Methods: This prospective cohort study comprised 230 patients (female 35%; median age 50 IQR 42-55) with recent-onset AF presenting to a university tertiary care center during a 6-year period. Management included intravenous vernakalant followed by electrical cardioversion in case of pharmacological failure.

Results: Within 11 min (IQR 8-29), sinus rhythm could be restored by sole pharmacological management in 167 patients (73%). A left ventricular function lower than 55% (OR 3.51 (1.45-8.52)) and prior atrial fibrillation episodes being classified as persistent (OR 2.33 (1.13-4.80)) were significant predictors for non-response to vernakalant. Electrical cardioversion was successful in all patients but one within 196 min (IQR 149-300) of administration of first dosage of vernakalant. No serious adverse events could be observed. 3 patients needed further in-patient care.

Conclusion: Management of recent-onset atrial fibrillation consisting of intravenous vernakalant followed by electrical cardioversion in case of failure appears safe and efficacious. Achieving a rapid conversion, this approach could potentially save resources and costs.

Keywords: Cardioversion; Recent-onset atrial fibrillation; Vernakalant.

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Figures

Fig. 1
Fig. 1
Study flow chart.
See this image and copyright information in PMC

References

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