Summary: In recent years, there has been a large amount of studies about the efficacy and safety of vernakalant or RSD1235, an antiarrhythmic agent, in treating the atrial fibrillation. This study was designed to assess the efficacy and safety of vernakalant in the treatment of AF. A total of 5 randomized controlled trials (RCTs) (n= 1153) met our inclusion criteria. The primary outcome was rate of converting to SR, and the secondary outcome was the rate of AEs of cardiac origin due to
vernakalant and the placebo or amiodarone. Meta-analyses were carried out using Mantel-Haenszel fixed-effects or random-effects models and heterogeneity was by the X(2) test. Vernakalant was superior in achieving SR for AF comparing to placebo or alternative anti-AADs (relative risk [RR] = 11.56, 95%; CI2 = 7.12 – 18.75). There was no heterogeneity among the trials (X(2) =0.59, P = 0.96). In analysing the adverse effects of cardiac origin, there was no significant difference between the two groups (RR= 0.90, 95% CI2 = 0.52 – 1.57).
Conclusion: In the conversion of AF to SR, vernakalant is highly effective without obviously raised side effects. Owing to only one study comparing vernakalant with amiodarone included in this study, the efficacy of vernakalant comparing to other antiarrhythmic agents needing more well designed double-blinded RCTs to be confirmed.
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