title: Propafenone versus vernakalant for conversion of recent-onset atrial fibrillation.
abstract: BACKGROUND
  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 compares vernakalant with propafenone. The aim of our study is to compare the time taken for conversion of recent-onset AF in patients treated with vernakalant 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 propafenone group 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 the vernakalant 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardiovascular Emergency Care Section, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Diego
authors.initials: D
authors.lastname: Conde
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Costabel
authors.forename: Martin
authors.initials: M
authors.lastname: Aragon
authors.forename: Florencia
authors.initials: F
authors.lastname: Lambardi
authors.forename: Andrés
authors.initials: A
authors.lastname: Klein
authors.forename: Andrea
authors.initials: A
authors.lastname: Corrales Barbosa
authors.forename: Marcelo
authors.initials: M
authors.lastname: Trivi
authors.forename: Alberto
authors.initials: A
authors.lastname: Giniger
mesh_terms: D000368:Aged; D000840:Anisoles / Q000009:adverse effects / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011405:Propafenone / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011759:Pyrrolidines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000840:Anisoles; D000889:Anti-Arrhythmia Agents; D011759:Pyrrolidines; D011405:Propafenone; C524581:vernakalant
keywords: Atrial fibrillation; Drugs; Propafenone; Treatment; Vernakalant