Conde Diego, Elissamburu Pablo, Lalor Nicolas, Rodriguez Leandro, Aragon Martin, Costabel Juan Pablo, Lambardi Florencia, Trivi Marcelo
Chief of Cardiovascular Emergency Care Section.
Staff Member of Clinical Cardiology Service.
J Atr Fibrillation. 2013 Aug 31;6(2):910. doi: 10.4022/jafib.910. eCollection 2013 Aug-Sep.
Vernakalant is a new, safe and effective drug used intravenously. It has proven to be more rapid in converting recent onset atrial fibrillation (AF) to sinus rhythm compared to placebo, amiodarone, propafenone and flecainide in clinical studies with few patients. At present no study has been conducted comparing these three drugs with a more substantial number of patients. The aim of our study is to compare the time to conversion to sinus rhythm, hospital stay and adverse events between vernakalant versus flecainide and propafenone in patients with a recent-onset AF. 150 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 50 patients; 50 patients received intravenous vernakalant; and 50 patients received a single oral dose of flecainide 300 mg. Clinical and laboratory variables were recorded. Baseline characteristics were similar in the three groups.Time to conversion to sinus rhythm was 12 minutes in the vernakalant group versus 151 minutes in the propafenone group and 162 minutes in flecainide group (p< 0.01) The hospital stay was 243 minutes in the vernakalant group versus 422 minutes in the propafenone group and 410 minutes in flecainide group (p<0.01) (Figure 2). No adverse events were reported. The time to conversion to sinus rhythm and hospital stay were statistically shorter in vernakalant group compared to flecainide and to propafenone. There were no adverse events in the three groups.
维纳卡兰是一种新型、安全有效的静脉用药。在少数患者参与的临床研究中，已证实它与安慰剂、胺碘酮、普罗帕酮和氟卡尼相比，能更快速地将近期发作的房颤（AF）转复为窦性心律。目前尚未进行过针对这三种药物且患者数量更多的比较研究。我们研究的目的是比较维纳卡兰与氟卡尼和普罗帕酮在近期发作房颤患者中转复为窦性心律的时间、住院时间及不良事件。前瞻性纳入了150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。50例患者口服单剂量600mg普罗帕酮；50例患者静脉注射维纳卡兰；50例患者口服单剂量300mg氟卡尼。记录临床和实验室变量。三组的基线特征相似。维纳卡兰组转复为窦性心律的时间为12分钟，普罗帕酮组为151分钟，氟卡尼组为162分钟（p<0.01）。维纳卡兰组的住院时间为243分钟，普罗帕酮组为422分钟，氟卡尼组为410分钟（p<0.01）（图2）。未报告不良事件。与氟卡尼和普罗帕酮相比，维纳卡兰组转复为窦性心律的时间和住院时间在统计学上更短。三组均无不良事件。
