Vernakalant Hydrochloride for the Rapid Conversion of Atrial Fibrillation After Cardiac Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

@article{Kowey2009VernakalantHF,
  title={Vernakalant Hydrochloride for the Rapid Conversion of Atrial Fibrillation After Cardiac Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial},
  author={Peter Russell Kowey and Paul Dorian and L. Brent Mitchell and Craig M. Pratt and Denis Roy and Peter J. Schwartz and Jerzy Sadowski and Dorota Sobczyk and Andrzej A Bochenek and Egon Toft},
  journal={Circulation: Arrhythmia and Electrophysiology},
  year={2009},
  volume={2},
  pages={652-659}
}
Background—Postoperative atrial arrhythmias are common and are associated with considerable morbidity. This study was designed to evaluate the efficacy and safety of vernakalant for the conversion of atrial fibrillation (AF) or atrial flutter (AFL) after cardiac surgery. Methods and Results—This was a prospective, randomized, double-blind, placebo-controlled trial of vernakalant for the conversion of AF or AFL after coronary artery bypass graft, valvular surgery, or both. Patients were randomly… 
Efficacy and safety of vernakalant in patients with atrial flutter: a randomized, double-blind, placebo-controlled trial.
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TLDR
Vernakalant modestly slowed AFL and ventricular response rates, and was well tolerated, but did not restore sinus rhythm in patients with AFL.
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TLDR
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TLDR
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TLDR
The POAF was effectively converted by vernakalant, and the conversion rate of POAF after valve surgery was lower when compared to isolated CABG.
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  • 2017
TLDR
Vernakalant was superior to ibutilide in converting recent‐onset atrial fibrillation to sinus rhythm in the emergency department setting and the conversion success within 90 min was significantly higher in the vernakalants group.
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TLDR
The new intravenous class III drug niferidil demonstrated high conversion rates of 84.6% in patients with persistent AF and 100% in Patients with persistent AFl, and may be used as a possible alternative to electrical cardioversion for pharmacological cardioversion of persistent AF/AFl.
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TLDR
An update on the safety and efficacy of intravenous vernakalant for the rapid cardioversion of AF is provided.
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TLDR
The time to conversion to sinus rhythm and hospital stay were statistically shorter in vernakalant group compared to flecainide and to propafenone and there were no adverse events in the three groups.
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References

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Vernakalant Hydrochloride for Rapid Conversion of Atrial Fibrillation: A Phase 3, Randomized, Placebo-Controlled Trial
TLDR
Vernakalant demonstrated rapid conversion of short-duration AF and was well tolerated and four vernakalants-related serious adverse events occurred in 3 patients.
Corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial.
TLDR
Intravenous hydrocortisone reduced the incidence of AF after cardiac surgery and patients receiving hydroc Corticosteroid did not have higher rates of superficial or deep wound infections, or other major complications.
Efficacy and safety of ibutilide fumarate for the conversion of atrial arrhythmias after cardiac surgery.
TLDR
Ibutilide is a useful and safe treatment alternative for the atrial arrhythmias that occur after cardiac surgery and means time to conversion decreased as the dose was increased.
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TLDR
The risk of post-operative AF should be reduced by the administration of amiodarone, a beta- blocker, sotalol or rate-limiting calcium antagonists, or by a rhythm control strategy following cardiothoracic surgery.
Pharmacologic control of rhythm: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery.
TLDR
Based on limited available evidence, amiodarone is recommended for pharmacologic conversion of postoperative AF and AFL in patients with depressed left ventricular function who do not need urgent electrical cardioversion and also because of its relatively favorable side-effects profile.
Pharmacologic prophylaxis: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery.
TLDR
It is recommended that strong consideration should be given to the prophylactic administration of Vaughan-Williams class II beta-blocking drugs as a means of lowering the incidence of new-onset post-cardiac surgery AF.
[Prevention and treatment of atrial fibrillation after cardiac surgery].
TLDR
The incidence of postoperative atrial fibrillation in cardiac surgery is still high despite major advances in anesthetic, pharmacological and surgical techniques, and among many pharmacological options, the best treatment is still to be defined.
Epidemiology, mechanisms, and risks: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery.
TLDR
Since postoperative AF often develops in patients with comorbidities who are predisposed to other complications and prolonged hospitalization, it is presently unclear whether the prevention of postoperativeAF will result in improved patient outcomes, particularly shorter hospitalizations.
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