Key result
Intravenous vernakalant shows no evidence of benefit over intravenous flecainide or propafenone for rapid conversion of recent onset atrial fibrillation to sinus rhythm.
Why the study?
Is intravenous vernakalant safe and efficacious for rapidly converting recent onset atrial fibrillation to sinus rhythm?
Is intravenous vernakalant safe and efficacious for rapidly converting recent onset atrial fibrillation to sinus rhythm?
Intravenous vernakalant is a safe and efficacious option for rapid conversion of recent-onset AF, though it lacks evidence of superiority over flecainide or propafenone.
Vernakalant offers no conversion advantage over class Ic agents; leaves open need for head-to-head RCTs in recent-onset AF.
INTRODUCTION: Intravenous vernakalant (Brinavess) has been developed and approved in Europe as a safe and efficacious drug to rapidly convert recent onset atrial fibrillation to sinus rhythm in patients with no minimal or structural heart disease. AREAS COVERED: The pharmacology of vernakalant and the pivotal Phase II and III clinical trials undertaken during its development are discussed with regard to safety and efficacy. An extensive PubMed search was used to identify suitable papers. EXPERT OPINION: 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.
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Brown et al. (2014) conducted a review in recent onset atrial fibrillation. Intravenous vernakalant vs. intravenous flecainide or propafenone was evaluated. Intravenous vernakalant shows no evidence of benefit over intravenous flecainide or propafenone for rapid conversion of recent onset atrial fibrillation to sinus rhythm.
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