Abstract 15296: Vernakalant Shows Superiority to Ibutilide in Recent-onset Atrial Fibrillation: A Randomized Controlled Trial at the Emergency Department
Introduction: Ibutilide is a rapid-acting antiarrhythmic drug with worldwide use for conversion of recent-onset atrial fibrillation. Vernakalant is a novel drug, which is likewise used intravenously, with proven effectiveness and safety compared to placebo and amiodarone in randomized clinical trials.
Hypothesis: We hypothesized that the time to sinus rhythm and the conversion rate within 90 minutes is different between vernakalant and ibutilide in patients with recent-onset atrial fibrillation.
Methods: A randomized, controlled, open-label trial registered at clinicaltrials.gov (NCT01447862) was performed in one hundred patients with recent-onset atrial fibrillation treated at the emergency department of a tertiary care hospital. Patients received up to two short-infusions of vernakalant (n= 49; 3mg/kg, 2mg/kg) or ibutilide (n= 51; 1mg, 1mg) according to the manufacturer’s instructions. Clinical and laboratory variables, adverse events, conversion rates and time to conversion were recorded.
Results: Time to conversion of AF to sinus rhythm was significantly shorter in the vernakalant group compared to the ibutilide group (median time: 10min vs. 26min, p=0.02), and likewise the conversion success within 90 minutes was significantly higher (69% vs. 43%, p=0.01) in the vernakalant group. In both groups no serious adverse events occurred.
Conclusion: Vernakalant was significantly faster and more effective in converting recent-onset atrial fibrillation to sinus rhythm at the emergency department.
Author Disclosures: A. Simon: None. J. Niederdöckl: None. E. Skyllouriotis: None. N. Schütz: None. C. Weiser: None. H. Herkner: None. A.N. Laggner: None. H. Domanovits: None. A.O. Spiel: Research Grant; Significant; This project was supported by a grant from the Jubiläumsfonds of the Austrian National Bank (#14891) to AO Spiel..
- © 2015 by American Heart Association, Inc.