Conde Diego, Costabel Juan Pablo, Aragon Martin, Lambardi Florencia, Trivi Marcelo
Cardiovascular Emergency Care Section, Instituto Cardiovascular de Buenos Aires, Argentina.
Cardiol J. 2014;21(3):304-8. doi: 10.5603/CJ.a2013.0113. Epub 2013 Aug 30.
Vernakalant is a new, safe and effective drug used intravenously, which has proved to be more rapid in converting recent onset atrial fibrillation (AF) to sinus rhythm compared to placebo, amiodarone, propafenone, and flecainide in clinical studies. Until now no study has been conducted comparing the perception of state of health in patients who received vernakalant versus propafenone or flecainide for conversion of recent-onset AF. The aim of our study is to compare the change of perception of state of health from screening to hour 2 in patients treated with vernakalant and propafenone or flecainide for conversion of recent-onset AF.
Eighty 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 30 patients, 30 patients received intravenous vernakalant and the remaining 20 patients received a single oral dose of flecainide 300 mg. Clinical, laboratory variables and perception of state of health from screening to hour 2 treated with these drugs measured by the EQ-5 D quality-of-life assessments visual analog scale were recorded.
Baseline characteristics were similar in the three groups. Treatment with vernakalant resulted in a significantly greater improvement in patient perception of state of health at hour 2 compared with propafenone and flecainide. In the vernakalant group, a mean increase (from baseline) of 12.1 points was seen compared with a mean increase of 5.4 points in the propafenone group or 5.2 points in flecainide group (p < 0.01).
The change of perception of state of health from screening to hour 2 treated with vernakalant had a significantly statistical improvement compared with propafenone or flecainide for conversion recent-onset AF.
维纳卡兰是一种新型、安全有效的静脉用药，临床研究表明，与安慰剂、胺碘酮、普罗帕酮和氟卡尼相比，其能更快地将近期发作的房颤（AF）转复为窦性心律。迄今为止，尚未有研究比较接受维纳卡兰与普罗帕酮或氟卡尼转复近期发作房颤的患者对健康状况的感知。我们研究的目的是比较接受维纳卡兰与普罗帕酮或氟卡尼转复近期发作房颤的患者从筛查到2小时时健康状况感知的变化。
前瞻性纳入80例近期发作房颤且无结构性心脏病、血流动力学稳定的患者。30例患者口服单次剂量600mg普罗帕酮，30例患者静脉注射维纳卡兰，其余20例患者口服单次剂量300mg氟卡尼。记录临床、实验室变量以及通过EQ-5D生活质量评估视觉模拟量表测量的这些药物治疗从筛查到2小时时的健康状况感知。
三组的基线特征相似。与普罗帕酮和氟卡尼相比，维纳卡兰治疗在2小时时患者健康状况感知有显著更大改善。维纳卡兰组平均增加（相对于基线）12.1分，而普罗帕酮组平均增加5.4分，氟卡尼组平均增加5.2分（p<0.01）。
与普罗帕酮或氟卡尼转复近期发作房颤相比，维纳卡兰治疗从筛查到2小时时健康状况感知变化有显著统计学改善。
