Kossaify Antoine
Electrophysiology Unit, Cardiology Division, Holy spirit University of Kaslik (USEK) and University Hospital Notre Dame des Secours, Byblos, Lebanon.
Drug Target Insights. 2019 Jul 3;13:1177392819861114. doi: 10.1177/1177392819861114. eCollection 2019.
Atrial fibrillation is the most common sustained cardiac arrhythmia, and its prevalence is increasing with age; also it is associated with significant morbidity and mortality. Rhythm control is advised in recent-onset atrial fibrillation, and in highly symptomatic patients, also in young and active individuals. Moreover, rhythm control is associated with lower incidence of progression to permanent atrial fibrillation. Vernakalant is a relatively new anti-arrhythmic drug that showed efficacy and safety in recent-onset atrial fibrillation. Vernakalant is indicated in atrial fibrillation (⩽7 days) in patients with no heart disease (class I, level A) or in patients with mild or moderate structural heart disease (class IIb, level B). Moreover, Vernakalant may be considered for recent-onset atrial fibrillation (⩽3 days) post cardiac surgery (class IIb, level B). Although it is mainly indicated in patients with recent-onset atrial fibrillation and with no structural heart disease, it can be given in moderate stable cardiac disease as alternative to Amiodarone. Similarly to electrical cardioversion, pharmacological cardioversion requires a minimal evaluation and cardioversion should be included in a comprehensive management strategy for better outcome.
心房颤动是最常见的持续性心律失常，其患病率随年龄增长而增加；它还与显著的发病率和死亡率相关。对于新发心房颤动患者，以及症状严重的患者，包括年轻且活跃的个体，建议进行节律控制。此外，节律控制与进展为永久性心房颤动的发生率较低相关。维纳卡兰是一种相对较新的抗心律失常药物，在新发心房颤动中显示出有效性和安全性。维纳卡兰适用于无心脏病的心房颤动患者（≤7天）（I类，A级）或轻度或中度结构性心脏病患者（IIb类，B级）。此外，心脏手术后新发心房颤动（≤3天）的患者可考虑使用维纳卡兰（IIb类，B级）。虽然它主要适用于新发心房颤动且无结构性心脏病的患者，但在中度稳定的心脏病中可作为胺碘酮的替代品使用。与电复律类似，药物复律需要进行最少的评估，并且复律应纳入综合管理策略以获得更好的结果。
