Vernakalant hydrochloride to treat atrial fibrillation

Abstract

As yet, there is no evidence of benefit over and above intravenous flecainide or propafenone for patients in whom vernakalant has a class 1a recommendation. As such, it is likely to be most useful in centres where only amiodarone is available.

Predictors of Conversion of Recent‐Onset Atrial Fibrillation Treated with Vernakalant

“…The episode of AF motivating the first consultation was the first event in 29.5% of patients, with average heart rate of 118.9 ± 27 beats per minute (bpm) and median time from symptoms onset of 4 hours …”

“…Vernakalant is an atrial‐selective antiarrhythmic agent that prolongs the refractory period, with little effect on ventricular repolarization. Vernakalant has a rapid distribution and onset of action; plasma concentrations decline approximately 50% in 10 minutes with a mean elimination half‐life of 3 hours …”

“…Although this study was performed in patients with chronic atrial fibrillation, in our study body mass index did not have any relation with conversion. We believe that this is related with vernakalant pharmacology, as the drug is poorly affected by fat mass …”

Open channel block of Kv1.5 channels by HMQ1611

“…A few known Kv1.5 channel blockers (e.g., BMS-394136, BMS-919343, MK-0448, F373280, XEN-D0101, and XEND0103/S66913) have entered clinical development for AF (EI-Haou et al, 2015). However, to date, only Vernakalant (BRINAVESS) has been introduced into clinical therapeutics for AF in Europe (Brown et al, 2014). As Vernakalant can also block several other cardiac ion channels, it appears that although I Kur blockade may contribute to its antifibrillatory effect, the most important action of this drug on AF is through atrial-selective blockade of peak sodium current (Burashnikov et al, 2012;Chiamvimonvat et al, 2017;Ravens and Odening, 2017).…”