PMID- 21175515
OWN - NLM
STAT- MEDLINE
DCOM- 20111014
LR  - 20121115
IS  - 1553-2712 (Electronic)
IS  - 1069-6563 (Linking)
VI  - 17
IP  - 11
DP  - 2010 Nov
TI  - Vernakalant hydrochloride: A novel atrial-selective agent for the cardioversion 
      of recent-onset atrial fibrillation in the emergency department.
PG  - 1175-82
LID - 10.1111/j.1553-2712.2010.00915.x [doi]
AB  - OBJECTIVES: Vernakalant is a relatively atrial-selective antiarrhythmic agent 
      that has been shown to successfully convert atrial fibrillation (AF) to normal 
      sinus rhythm for some patients whose onset of dysrhythmia occurred less than 7 
      days previously. This study sought to evaluate the efficacy and safety of 
      vernakalant for patients with recent-onset AF. METHODS: This was a post hoc 
      analysis of patients with recent-onset AF (> 3 to </= 48 hours) enrolled in the 
      double-blind, placebo-controlled Atrial arrhythmia Conversion Trial (ACT) I and 
      the open-label ACT IV trials. The studies enrolled adults presenting with AF to 
      78 emergency departments (ED) and cardiac clinics in six countries. Patients 
      received a 10-minute intravenous infusion of vernakalant or placebo, followed by 
      an additional infusion if necessary. Efficacy assessments included conversion to 
      sinus rhythm within 90 minutes and median time to conversion. Safety evaluations 
      included telemetry, Holter monitoring, and adverse events (AEs). RESULTS: Of the 
      290 patients, 229 received vernakalant, 61 received placebo, and the overall mean 
      age was 59 years. The vernakalant and placebo groups were similar. Of all 
      patients given vernakalant, 136 (59.4%) converted to sinus rhythm within 90 
      minutes, compared with three (4.9%) placebo patients. The median time to 
      conversion with vernakalant was 12 minutes (interquartile range = 7-24.5 
      minutes). Clinically significant bradycardia and hypotension were uncommon, and 
      no cases of torsade de pointes or ventricular fibrillation occurred. CONCLUSIONS: 
      Vernakalant rapidly converted recent-onset AF to sinus rhythm in over half of 
      patients, was well tolerated, and has the potential to offer an important 
      therapeutic option for rhythm control of recent-onset AF in the ED.
CI  - (c) 2010 by the Society for Academic Emergency Medicine.
FAU - Stiell, Ian G
AU  - Stiell IG
AD  - Department of Emergency Medicine, Ottawa Hospital Research Institute, University 
      of Ottawa, Canada. istiell@ohri.ca
FAU - Dickinson, Garth
AU  - Dickinson G
FAU - Butterfield, Noam N
AU  - Butterfield NN
FAU - Clement, Catherine M
AU  - Clement CM
FAU - Perry, Jeffrey J
AU  - Perry JJ
FAU - Vaillancourt, Christian
AU  - Vaillancourt C
FAU - Calder, Lisa A
AU  - Calder LA
LA  - eng
SI  - ClinicalTrials.gov/NCT00281554
SI  - ClinicalTrials.gov/NCT00468767
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Acad Emerg Med
JT  - Academic emergency medicine : official journal of the Society for Academic 
      Emergency Medicine
JID - 9418450
RN  - 0 (Anisoles)
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Placebos)
RN  - 0 (Pyrrolidines)
RN  - 9G468C8B13 (vernakalant)
SB  - IM
EIN - Acad Emerg Med. 2011 Feb;18(2):224
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anisoles/*pharmacology/standards
MH  - Anti-Arrhythmia Agents/*pharmacology/standards
MH  - Atrial Fibrillation/*drug therapy
MH  - Double-Blind Method
MH  - Emergency Service, Hospital
MH  - Female
MH  - Humans
MH  - Infusions, Intravenous
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Placebos
MH  - Pyrrolidines/*pharmacology/standards
MH  - Treatment Outcome
EDAT- 2010/12/24 06:00
MHDA- 2011/10/15 06:00
CRDT- 2010/12/24 06:00
PHST- 2010/12/24 06:00 [entrez]
PHST- 2010/12/24 06:00 [pubmed]
PHST- 2011/10/15 06:00 [medline]
AID - 10.1111/j.1553-2712.2010.00915.x [doi]
PST - ppublish
SO  - Acad Emerg Med. 2010 Nov;17(11):1175-82. doi: 10.1111/j.1553-2712.2010.00915.x.