Flecainide or Propafenone vs Vernakalant for Conversion of Recent-Onset Atrial Fibrillation

Conde, Diego; Costabel, Juan Pablo; Aragón, Martín; Caro, Milagros; Ferro, Alejandra; Klein, Andres; Trivi, Marcelo; Giniger, Alberto

doi:10.1016/j.cjca.2013.01.002

Cited by 8 publications

(10 citation statements)

References 4 publications

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“…Antiarrhythmic Drugs in Atrial Fibrillation DOI: http://dx.doi.org/10.5772/intechopen.89406 moderate structural heart disease as well as post-cardiac surgery AF. It is also more effective than flecainide and propafenone, again in recent-onset AF, and is well tolerated while to most common side effects including paresthesia, dysgeusia, dizziness, sneezing, and nausea [35,36].…”

Section: Other Antiarrhythmicsmentioning

confidence: 99%

Antiarrhythmic Drugs in Atrial Fibrillation

Simović¹,

Srejović²,

Živković³

et al. 2020

Epidemiology and Treatment of Atrial Fibrillation

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Atrial fibrillation (AF) represents the most common sustained heart rhythm abnormality. It presents in paroxysmal and persistent forms. The pathogenesis of AF is still debatable with several proposed mechanisms. The main pathway for diagnosis of AF is through electrocardiographic record. Treatment strategies can be divided into two strategies: rate and rhythm control. For rhythm control, antiarrhythmic drugs, direct current cardioversion, and electrophysiological ablation are used, while for rate control, chronotropic drugs are being used, while AV node ablation is required in order to reduce rapid ventricular rate, which is often observed in patients with AF. The rhythm control strategy implies the use of cardioversion to convert AF to normal, sinus rhythm. Cardioversion can be either pharmacological or electrical. Rate control strategy can be implied to patients with permanent AF but should also imply for the patients with paroxysmal AF when relapse occurs. Rapid ventricular rates can cause palpitations or even a syncope and other rate-related symptoms; however, these high ventricular rates lead to degradation of left ventricle performance, mitral regurgitation, and further dilatation of the left atrium. The main antiarrhythmic drugs used in treatment of AF are propafenone, flecainide, beta-blockers, amiodarone, dronedarone, dofetilide, vernakalant, and ranolazine.

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Section: Other Antiarrhythmicsmentioning

confidence: 99%

Antiarrhythmic Drugs in Atrial Fibrillation

Simović¹,

Srejović²,

Živković³

et al. 2020

Epidemiology and Treatment of Atrial Fibrillation

View full text Add to dashboard Cite

show abstract

“…5 In addition, in a comparative study with flecainide, a superior conversion rate and a more rapid conversion was observed. 6 …”

Section: Pharmacologic Conversion Of Atrial Fibrillation In Heart Faimentioning

confidence: 99%

“…In a small prospective single-center study, superiority to flecainide in conversion rate and conversion time was demonstrated. 6 Vernakalant was therefore included in the 2012 focused update of the European Society of Cardiology (ESC) guidelines for management of AF and received a class 1A recommendation for pharmacologic conversion of recent-onset AF in patients without severe structural heart disease. 7 In a meta-analysis, in which data from patients with ischemic heart disease or previous cardiac surgery were extracted, no negative effect of vernakalant was reported.…”

mentioning

confidence: 99%

Vernakalant in an Experimental Model of Pacing-Induced Heart Failure: Lack of Proarrhythmia Despite Prolongation of Repolarization

Frommeyer

Grotthoff

Fischer

et al. 2014

Journal of Cardiac Failure

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“…A recently published short report showed in 51 recent-onset AF patients without structural heart diseases that AF conversion to sinus rhythm is faster and the length of hospital stay is shorter with vernakalant than with flecainide or propafenone 54. Although vernakalant is more expensive than amiodarone and flecainide,55 this reduction in length of hospital stay should reduce patient costs.…”

Section: Clinical Considerationsmentioning

confidence: 99%

Safety and efficacy of vernakalant for acute cardioversion of atrial fibrillation: an update

Tsuji¹,

Dobrev²

2013

VHRM

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Intravenous vernakalant has recently been approved in Europe as an atrial-selective antiarrhythmic drug for the conversion of recent-onset atrial fibrillation (AF). It inhibits atrial-selective K+ currents (IK,ACh and IKur) and causes rate-dependent atrial-predominant Na+ channel block, with only a small inhibitory effect on the rapid delayed rectifier K+ current (IKr) in the ventricle. Due to its atrial-selective properties, vernakalant prolongs the effective refractory period of the atria with minimal effects on the ventricles, being associated with a low proarrhythmic risk for torsades de pointes arrhythmias. Five pivotal clinical trials consistently demonstrated that vernakalant rapidly terminates AF with stable maintenance of sinus rhythm for up to 24 hours. A head-to-head comparative trial showed that the 90-minute conversion rate of vernakalant was substantially higher than that of amiodarone. Initially, a longer-acting oral formulation of vernakalant was shown to be effective and safe in preventing AF recurrence after cardioversion in a Phase IIb study. However, the clinical studies testing oral vernakalant for maintenance of sinus rhythm after AF cardioversion were prematurely halted for undisclosed reasons. This review article provides an update on the safety and efficacy of intravenous vernakalant for the rapid cardioversion of AF.

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Flecainide or Propafenone vs Vernakalant for Conversion of Recent-Onset Atrial Fibrillation

Cited by 8 publications

References 4 publications

Antiarrhythmic Drugs in Atrial Fibrillation

Antiarrhythmic Drugs in Atrial Fibrillation

Vernakalant in an Experimental Model of Pacing-Induced Heart Failure: Lack of Proarrhythmia Despite Prolongation of Repolarization

Safety and efficacy of vernakalant for acute cardioversion of atrial fibrillation: an update

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