Effectiveness and safety of vernakalant vs flecainide for cardioversion of atrial fibrillation in the emergency department: the VERITA study
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View abstract on PubMed
Summary
This summary is machine-generated.Vernakalant and flecainide show similar effectiveness for atrial fibrillation (AF) conversion. Vernakalant offers better early treatment results, reduced AF recurrence, and fewer emergency department visits within six months.
Area Of Science
- Cardiology
- Pharmacology
Background
- Vernakalant is approved internationally but not in the U.S. due to FDA safety concerns, sparking debate.
- Intravenous (IV) vernakalant and flecainide are used for atrial fibrillation (AF) conversion.
Purpose Of The Study
- Compare the effectiveness and safety of IV vernakalant versus IV flecainide for converting AF to sinus rhythm (SR) in an emergency department (ED).
Main Methods
- Retrospective observational study of AF episodes treated with vernakalant or flecainide in the ED (January 2012-December 2022).
- Primary outcome: percentage of episodes converted to SR during ED stay.
- Secondary outcomes: clinical evolution, ED re-presentations, and outpatient cardiology consultations over 6 months.
Main Results
- Vernakalant converted 76.4% of episodes to SR versus 69.5% for flecainide (p=0.124).
- Vernakalant demonstrated lower AF recurrence (20.1% vs. 29.1%; p=0.043) and fewer ED visits for recurrence (0.24 vs. 0.48; p=0.001) at 6 months.
- Vernakalant was more effective for early treatment (<12h onset) and AF with rapid ventricular response.
Conclusions
- Vernakalant and flecainide have comparable safety and effectiveness profiles.
- Vernakalant shows advantages in early treatment, faster SR conversion, reduced AF recurrence, and fewer subsequent ED visits.
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