Vernakalant bests amiodarone in AF treatment
MedWire News: The novel intravenous anti-arrhythmic drug vernakalant is more effective than amiodarone for rapid conversion of atrial fibrillation (AF) to sinus rhythm, results of the AVRO randomized clinical trial show.
AF conversion to sinus rhythm was achieved within 90 minutes in 60 (51.7%) of 116 patients who received vernakalant compared with six (5.2%) of 116 given amiodarone (p<0.0001).
AVRO investigator Jon Camm (St George’s, University of London, UK) presented the results at Heart Rhythm 2010 in Denver, Colorado, USA.
The double blind trial included 254 patients with recent onset sustained (3–48 hours) AF who were randomly assigned to receive two serial doses of vernakalant (3 mg/kg followed by an additional 10-min infusion of 2 mg/kg if patient remained in AF after 15-min observation period) or amiodarone (60-min infusion of 5 mg/kg followed by an additional 60-min maintenance infusion of 50 mg).
Sham infusions were administered in a second line to maintain blinding.
Vernakalant was also associated with higher rate of relief from AF symptoms within 90 min than amiodarone (53.4% vs 32.8%, p=0.0012).
The investigational drug was generally well tolerated, with serious adverse events (five vs two amiodarone patients) and events leading to discontinuation of study grug (three vs one amiodarone patient) uncommon. Transient symptoms with vernakalant included dysgeusia, cough, and nausea in around 3–7% of patients.
The results indicate that vernakalant is a promising alternative anti-arrhythmic to amiodarone for acute conversion of recent onset AF.
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By Caroline Price