Vernakalant--a promising therapy for conversion of recent-onset atrial fibrillation.
BACKGROUND
This paper reviews the pharmacology, electrophysiology, efficacy and safety of intravenous and oral vernakalant hydrochloride (RSD-1235), a novel antiarrhythmic drug that has relative atrial selectivity by blocking potassium channels that are present in the atria and not the ventricle. In addition, this drug has important rate-dependent sodium channel blocking properties.


METHODS
Currently, there few commercially approved intravenous antiarrhythmic agents for the conversion of atrial fibrillation. Intravenously, vernakalant has been demonstrated to be useful in terminating over 50% of recent-onset atrial fibrillation (< 7 days duration) with minimal ventricular proarrhythmic effects. Intravenous vernakalant is not effective in terminating atrial flutter. Oral vernakalant is currently undergoing study and appears to be effective in suppressing atrial fibrillation recurrences after cardioversion of persistent atrial fibrillation.


CONCLUSIONS
Intravenous vernakalant has the potential to be an important agent in the conversion of atrial fibrillation and oral vernakalant may be a useful drug for the suppression of atrial fibrillation recurrences.
Naccarelli
Gerald V
GV
Penn State University College of Medicine, Division of Cardiology, 500 University Dr Room H 1.511, Hershey, PA 17033, USA. gnaccarelli@psu.edu
Wolbrette
Deborah L
DL
Samii
Soraya
S
Banchs
Javier E
JE
Penny-Peterson
Erica
E
Stevenson
Robert
R
Gonzalez
Mario D
MD
D000284:Administration, Oral; D000840:Anisoles / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D004341:Drug Evaluation; D004554:Electric Countershock; D004594:Electrophysiology; D006801:Humans; D007275:Injections, Intravenous; D007473:Ion Channels / Q000037:antagonists & inhibitors; D011759:Pyrrolidines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D055502:Secondary Prevention
D000840:Anisoles; D000889:Anti-Arrhythmia Agents; D007473:Ion Channels; D011759:Pyrrolidines; C524581:vernakalant