title: Flecainide versus vernakalant for conversion of recent-onset atrial fibrillation.
abstract: BACKGROUND
  An oral single dose of flecainide is used worldwide for conversion of recent onset atrial fibrillation (AF) in hemodynamically stable patients without structural heart disease. Vernakalant is a novel, rapid drug, which is used intravenously, with proven effectiveness and safety compared to placebo and amiodarone in randomized clinical trials. The aim of our study was to compare the time taken for conversion of recent onset AF in patients treated with vernakalant or flecainide.
  
  
  METHODS
  This is a sequential study in which 32 hemodynamically stable patients with recent onset AF without structural heart disease were prospectively and consecutively included in two periods, one for each drug. A single oral dose of flecainide 300 mg was administered to 15 patients and 17 patients 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 163 min (120-300) in the flecainide group versus 10 min (6-18) in the vernakalant group (p=0.0001).
  
  
  CONCLUSIONS
  Time to conversion of AF to sinus rhythm was significantly shorter in the vernakalant group compared with the flecainide group, and was associated with shorter hospital stay. This reduction in hospital stay length may produce benefits in patients' medical care, costs and welfare.
authors.affiliation: Instituto Cardiovascular de Buenos Aires, Argentina. Electronic address: drconde@hotmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Conde
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Costabel
authors.forename: Milagros
authors.initials: M
authors.lastname: Caro
authors.forename: Alejandra
authors.initials: A
authors.lastname: Ferro
authors.forename: Florencia
authors.initials: F
authors.lastname: Lambardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Corrales Barboza
authors.forename: Augusto
authors.initials: A
authors.lastname: Lavalle Cobo
authors.forename: Marcelo
authors.initials: M
authors.lastname: Trivi
mesh_terms: D000368:Aged; D000840:Anisoles / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D005260:Female; D005424:Flecainide / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011759:Pyrrolidines / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000840:Anisoles; D000889:Anti-Arrhythmia Agents; D011759:Pyrrolidines; C524581:vernakalant; D005424:Flecainide
keywords: Atrial fibrillation; Flecainide; Vernakalant