Vernakalant and electrical cardioversion for AF - Safe and effective.

Area of Science:

• Cardiology
• Pharmacology

Background:

• Rapid restoration of sinus rhythm is crucial for managing recent-onset atrial fibrillation.
• Vernakalant is a multi-channel blocking agent used for pharmacological cardioversion.

Purpose of the Study:

• To assess the safety and efficacy of intravenous vernakalant combined with external electrical cardioversion for recent-onset atrial fibrillation.
• To evaluate predictors of non-response to vernakalant.

Main Methods:

• Prospective cohort study of 230 patients with recent-onset atrial fibrillation.
• Management involved intravenous vernakalant, followed by electrical cardioversion if pharmacological cardioversion failed.

Main Results:

• Pharmacological cardioversion with vernakalant alone restored sinus rhythm in 73% of patients within 11 minutes.
• Low left ventricular function (<55%) and persistent atrial fibrillation were predictors of non-response.
• Electrical cardioversion was successful in all but one patient, with a median time of 196 minutes from vernakalant administration.

Conclusions:

• Intravenous vernakalant followed by electrical cardioversion is a safe and effective strategy for recent-onset atrial fibrillation.
• This approach achieves rapid rhythm conversion, potentially reducing healthcare costs and resource utilization.