Intraprocedural Conversion Efficacy of Intravenous Nifekalant Administration for Persistent Atrial Fibrillation after Pulmonary Vein Isolation

Di, Chengye; Gao, Peng; Wang, Qun; Wu, Yanxi; Lin, Wenhua

doi:10.1536/ihj.20-328

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…A total of 37 of these were further excluded for various reasons, such as insufficient data and inappropriate controls. Finally, 405 articles were excluded and 12 research studies met all the inclusion criteria (10,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). A flow chart of the study selection process is shown in Fig.…”

Section: Results Of the Article Searchmentioning

confidence: 99%

Meta‑analysis of the efficacy and safety of nifekalant in the conversion of atrial fibrillation

Liu

Wang

et al. 2022

Exp Ther Med

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Atrial fibrillation (AF) is the most common type of supraventricular tachyarrhythmia. Nifekalant is a new class III antiarrhythmic drug approved for the treatment of ventricular tachyarrhythmias, but its effectiveness in converting AF to sinus rhythm remains unclear. The present analysis aimed to investigate the effect of nifekalant in the conversion of AF. PubMed, Cochrane Library and China National Knowledge Infrastructure databases were systematically used to search relevant studies published between 1999 (data at which the drug was first approved for marketing in Japan) and 2022. Randomized clinical trials, prospective studies and retrospective studies on the use of nifekalant for AF were screened. The study metrics included the success rate of the conversion of AF, the mean time to conversion, the success rate of 12 months after a single AF catheter ablation procedure and the incidence of adverse events. The eligible studies screened included six randomized clinical trials, three prospective studies and three retrospective studies, totalling 12 studies with 1,162 patients. The risk ratio (RR) for successful conversion in the nifekalant and control groups was 1.95 [95% confidence interval (CI), 1.23-3.08; P=0.005] and the mean difference for the mean time to conversion was -1.73 [95% CI, -2.69-(-0.77); P= 0.0004]. Statistically significant differences were observed between nifekalant and control groups. Subgroup analysis revealed a statistically significant difference in the success rate of conversion following catheter ablation in the nifekalant group compared with the amiodarone group and the RR value was 1.95 (95% CI, 1.37-2.77; P= 0.0002). Statistically significant difference was observed compared with the electrical cardioversion group and the RR value was 0.90 (95% CI, 0.84-0.98; P=0.01). However, the combined RR values for the two groups were 1.18 (95% CI, 0.85-1.65; P<0.0002). The RR value for adverse events was 0.85 (95% CI, 0.51-1.43; P=0.55), with no statistically significant differences between nifekalant and control groups. In conclusion, the results demonstrated that the success rate and time to conversion in the nifekalant group were improved compared with those in the control group, particularly after catheter ablation, and the conversion effect with nifekalant was significantly improved compared with that in the control group.

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Section: Results Of the Article Searchmentioning

confidence: 99%

Meta‑analysis of the efficacy and safety of nifekalant in the conversion of atrial fibrillation

Liu

Wang

et al. 2022

Exp Ther Med

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“…Nifekalant is mainly used for hemodynamically unstable ventricular arrhythmia. However, it has also been shown to reduce the defibrillation threshold of AF and terminate AF 1,2 . Recently, Masuda et al reported that nifekalant could also facilitate the identification of extra‐PV foci by suppressing IRAF 3,4 .…”

Section: Figurementioning

confidence: 99%

“…However, it has also been shown to reduce the defibrillation threshold of AF and terminate AF. 1 , 2 Recently, Masuda et al reported that nifekalant could also facilitate the identification of extra‐PV foci by suppressing IRAF. 3 , 4 Using nifekalant, we aimed to suppress the immediate recurrence of intra‐SVC fibrillation to evaluate SVC gap conduction.…”

mentioning

confidence: 99%

Nifekalant unmasked residual gap of superior vena cava isolation by suppressing immediate recurrence of intra‐superior vena cava fibrillation

Sekihara¹,

Oka²,

Nakano³

et al. 2022

Journal of Arrhythmia

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“…The drug exerts its antiarrhythmic effects mainly by blocking the rapid delayed rectifier K + current (I Kr ), thus prolonging the action potential duration (APD) and the effective refractory period (ERP) of atrial and ventricular myocytes [12][13][14]. In some AF centers, Nifekalant is already being used for immediate conversion of AF after ablation and to detect the masked critical sites of patients in whom sinus rhythm cannot be restored during RFCA [15][16][17]. The incidence of AF termination reported by these centers after the administration of nifekalant was approximately 65% [15][16][17]; moreover, the AF termination by nifekalant injection could be a predictor of higher atrial arrhythmia-free survival following the procedure [15].…”

Section: Introductionmentioning

confidence: 99%

“…In some AF centers, Nifekalant is already being used for immediate conversion of AF after ablation and to detect the masked critical sites of patients in whom sinus rhythm cannot be restored during RFCA [15][16][17]. The incidence of AF termination reported by these centers after the administration of nifekalant was approximately 65% [15][16][17]; moreover, the AF termination by nifekalant injection could be a predictor of higher atrial arrhythmia-free survival following the procedure [15]. Hence, a prospective cohort study was conducted to develop and validate a novel prognostic model based on different responses using nifekalant and other predictors of AF recurrence risk for 1-year after the first RFCA among patients with PeAF.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Novel Prognostic Model Predicting the Atrial Fibrillation Recurrence Risk for Persistent Atrial Fibrillation Patients Treated with Nifekalant During the First Radiofrequency Catheter Ablation

Zhai

Zhu

Xiao

et al. 2022

Cardiovasc Drugs Ther

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Background This study aimed to establish and assess a prediction model for patients with persistent atrial fibrillation (AF) treated with nifekalant during the first radiofrequency catheter ablation (RFCA). Methods In this study, 244 patients with persistent AF from January 17, 2017 to December 14, 2017, formed the derivation cohort, and 205 patients with persistent AF from December 15, 2017 to October 28, 2018, constituted the validation cohort. The least absolute shrinkage and selection operator regression was used for variable screening and the multivariable Cox survival model for nomogram development. The accuracy and discriminative capability of this predictive model were assessed according to discrimination (area under the curve [AUC]) and calibration. Clinical practical value was evaluated using decision curve analysis. Results Body mass index, AF duration, sex, left atrial diameter, and the different responses after nifekalant administration were identified as AF recurrence-associated factors, all of which were selected for the nomogram. In the development and validation cohorts, the AUC for predicting 1-year AF-free survival was 0.863 (95% confidence interval (CI) 0.801–0.926) and 0.855 (95% CI 0.782–0.929), respectively. The calibration curves showed satisfactory agreement between the actual AF-free survival and the nomogram prediction in the derivation and validation cohorts. In both groups, the prognostic score enabled stratifying the patients into different AF recurrence risk groups. Conclusions This predictive nomogram can serve as a quantitative tool for estimating the 1-year AF recurrence risk for patients with persistent AF treated with nifekalant during the first RFCA.

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Intraprocedural Conversion Efficacy of Intravenous Nifekalant Administration for Persistent Atrial Fibrillation after Pulmonary Vein Isolation

Cited by 4 publications

References 25 publications

Meta‑analysis of the efficacy and safety of nifekalant in the conversion of atrial fibrillation

Meta‑analysis of the efficacy and safety of nifekalant in the conversion of atrial fibrillation

Nifekalant unmasked residual gap of superior vena cava isolation by suppressing immediate recurrence of intra‐superior vena cava fibrillation

Development and Validation of a Novel Prognostic Model Predicting the Atrial Fibrillation Recurrence Risk for Persistent Atrial Fibrillation Patients Treated with Nifekalant During the First Radiofrequency Catheter Ablation

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