Introduction: Vernakalant is a new, safe and effective drug used intravenously, which has
proved to be more rapid in converting recent onset AF to sinus rhythm compared
to placebo, amiodarone, propafenone and flecainide in clinical studies with few
patients. Up to the present no study has been conducted comparing these three
drugs with a substantial number of patients.
The aim of our
study is to compare the time to conversion to sinus rhythm, hospital stay and
adverse events between vernakalant or flecainide and propafenone in patients
with a recent-onset atrial fibrillation.
Materials and Methods: 150 hemodynamically stable patients with recent onset AF without
structural heart disease were prospectively included. A single oral dose of
propafenone 600 mg was administered to 50 patients, 50 patients received intravenous
vernakalant and other 50 patients received a single oral dose of flecainide 300
mg. Clinical and laboratory variables were recorded.
Results: Baseline characteristics were similar in the three groups. Time to
conversion to sinus rhythm was 12 minutes in the vernakalant group versus 151
minutes in the propafenone group and 162 minutes in flecainide group (p< 0.01).
The hospital stay was
243 minutes in the vernakalant group
versus 422 minutes in the propafenone group and 410 minutes in flecainide group
(p< 0.01) (Figure 2).
No adverse events
Conclusion: The time to conversion to sinus rhythm and hospital stay were
statistical shorter in vernakalant group compared with flecainide and
propafenone. There were no adverse events in the three groups.
Credits: Diego Conde; Pablo Elissamburu; Nicolas Lalor Leandro Rodriguez; Martin Aragon; Juan Pablo Costabel; Florencia Lambardi; Marcelo Trivi