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Vernakalant and electrical cardioversion for AF - Safe and effective.


ABSTRACT:

Aims

Rapid restoration of sinus rhythm is an integral part of the management of recent-onset atrial fibrillation. We aimed to assess safety and efficacy of vernakalant, a multi-channel blocking agent, in combination with external electrical cardioversion.

Methods

This prospective cohort study comprised 230 patients (female 35%; median age 50 IQR 42-55) with recent-onset AF presenting to a university tertiary care center during a 6-year period. Management included intravenous vernakalant followed by electrical cardioversion in case of pharmacological failure.

Results

Within 11?min (IQR 8-29), sinus rhythm could be restored by sole pharmacological management in 167 patients (73%). A left ventricular function lower than 55% (OR 3.51 (1.45-8.52)) and prior atrial fibrillation episodes being classified as persistent (OR 2.33 (1.13-4.80)) were significant predictors for non-response to vernakalant. Electrical cardioversion was successful in all patients but one within 196?min (IQR 149-300) of administration of first dosage of vernakalant. No serious adverse events could be observed. 3 patients needed further in-patient care.

Conclusion

Management of recent-onset atrial fibrillation consisting of intravenous vernakalant followed by electrical cardioversion in case of failure appears safe and efficacious. Achieving a rapid conversion, this approach could potentially save resources and costs.

SUBMITTER: Simon A 

PROVIDER: S-EPMC6626112 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Vernakalant and electrical cardioversion for AF - Safe and effective.

Simon Alexander A   Niederdoeckl Jan J   Janata Karin K   Spiel Alexander Oskar AO   Schuetz Nikola N   Schnaubelt Sebastian S   Herkner Harald H   Cacioppo Filippo F   Laggner Anton Norbert AN   Domanovits Hans H  

International journal of cardiology. Heart & vasculature 20190711


<h4>Aims</h4>Rapid restoration of sinus rhythm is an integral part of the management of recent-onset atrial fibrillation. We aimed to assess safety and efficacy of vernakalant, a multi-channel blocking agent, in combination with external electrical cardioversion.<h4>Methods</h4>This prospective cohort study comprised 230 patients (female 35%; median age 50 IQR 42-55) with recent-onset AF presenting to a university tertiary care center during a 6-year period. Management included intravenous verna  ...[more]

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