Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .
A Randomized, Placebo-Controlled Study of Vernakalant (Oral) for the Prevention of Atrial Fibrillation Recurrence After Cardioversion
Background — Vernakalant , a relatively atrial-selective antiarrhythmic drug , has previously demonstrated efficacy for the acute conversion of atrial fibrillation ( AF ) to sinus rhythm . This study was design ed to determine the most appropriate oral dose of vernakalant for the prevention of AF recurrence postcardioversion . Methods and Results — Patients with nonpermanent AF were r and omized to 150 , 300 , or 500 mg vernakalant or placebo twice daily for up to 90 days . The efficacy analysis was conducted on 605 of 735 patients who entered the maintenance phase on day 3 after cardioversion . The time to the first recurrence of symptomatic sustained AF was significantly longer in the 500 mg vernakalant group , with a median of > 90 days versus 29 days in the placebo group ( hazard ratio , 0.735 ; P=0.0275 ) . No significant effect was seen at the lower doses . The percent of patients in sinus rhythm at day 90 was 41 % , 39 % , and 49 % in the 150-mg ( n=147 ) , 300-mg ( n=148 ) , and 500-mg ( n=150 ) vernakalant groups , respectively , compared with 36 % in the placebo group ( n=160 ) . There were no vernakalant-related proarrhythmic events . Related serious adverse events occurred in 2 patients in the 150-mg vernakalant group and in 1 patient in each of the other groups . Conclusions — Vernakalant , 500 mg twice daily , appears to be effective and safe for the prevention of AF recurrence after cardioversion . The absence of proarrhythmia and favorable safety profile is an important finding for the drug . Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT00526136
Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .