Propafenone versus vernakalant for conversion of recent-onset atrial fibrillation

INTRODUCTION:

An oral loading dose of propafenone 600 mg is used in our center as in other places around the world for conversion of recent-onset atrial fibrillation (AF) in patients without structural heart disease. Vernakalant is a novel, safe, and effective drug used intravenously and has proved to be more rapid in converting recent-onset AF to sinus rhythm compared with placebo and amiodarone. There is no study that comparesvernakalant with propafenone. The aim of our study is to compare the time taken for conversion of recent-onset AF in patients treated withvernakalant and propafenone.

METHODS:

Thirty-six hemodynamically stable patients with recent-onset AF without structural heart disease were prospectively included. A single oral dose of propafenone 600 mg was administered to 19 patients and 17 received intravenous vernakalant. Clinical and laboratory variables, conversion rate, and time to conversion were recorded.

RESULTS:

Baseline characteristics were similar in both groups. Time to conversion to sinus rhythm was of 166 min (120-300) in the propafenonegroup versus 9 min (6-18) in the vernakalant group (P = 0.0001). Conversion rate was of 78% in the propafenone group at 8 h and of 93% in thevernakalant group at 2 h; yet, this difference was not statistically significant (P = 0.4). Time to conversion had a direct impact in hospital stay, which was 43% shorter in the vernakalant group (P = 0.0001).

CONCLUSION:

Time to conversion of AF to sinus rhythm was significantly shorter in the vernakalant group compared with the propafenone group and was associated with shorter hospital stay.

לקריאת המאמר:

Conde D, Costabel JP, Aragon M, Lambardi F, Klein A, Corrales Barbosa A, Trivi M, Giniger A. Propafenone versus vernakalant for conversion of recent-onset atrial fibrillation.Cardiovasc Ther. 2013 Dec;31(6):377-80.