Document Detail

Vernakalant: A novel agent for the termination of atrial fibrillation.
MedLine Citation:
PMID:  20592320     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The pharmacology, pharmacokinetics, safety, clinical efficacy, and role of intravenous vernakalant hydrochloride for the rapid conversion of atrial fibrillation (AF) to normal sinus rhythm are reviewed. SUMMARY: Vernakalant, currently being evaluated by the Food and Drug Administration (FDA), for the termination of atrial fibrillation, differs in pharmacology from other antiarrhythmics; it achieves action potential interference through blockade of sodium and potassium currents. Vernakalant's actions appear to be directed at relatively atrial-selective potassium currents, which result in lengthening of the atrial action potential and prolongation of the atrial action potential plateau, while not significantly affecting the Q-T interval or the ventricular effective refractory period. As a result, the proarrhythmic effects observed with all other agents approved by FDA for the treatment of AF are eliminated. In clinical trials of vernakalant versus placebo, a statistically significant number of patients converted to normal sinus rhythm after receiving vernakalant. For patients with atrial fibrillation continuing for 3-72 hours, the median time to conversion was between 8 and 14 minutes, with 79% of those who converted remaining in sinus rhythm at 24 hours. CONCLUSION: Intravenous vernakalant, a novel, relatively atrial-selective antiarrhythmic agent, appears to offer an effective and safe approach to the rapid conversion of recent-onset AF to normal sinus rhythm.
Miki Finnin
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  67     ISSN:  1535-2900     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1157-64     Citation Subset:  IM    
College of Pharmacy, University of Oklahoma, Schusterman Center, Tulsa, OK 74135-2512, USA.
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MeSH Terms
Anisoles / adverse effects,  pharmacology,  therapeutic use*
Anti-Arrhythmia Agents / adverse effects,  pharmacology,  therapeutic use*
Atrial Fibrillation / drug therapy*,  physiopathology
Infusions, Intravenous
Potassium Channel Blockers / adverse effects,  pharmacology,  therapeutic use
Pyrrolidines / adverse effects,  pharmacology,  therapeutic use*
Sodium Channel Blockers / adverse effects,  pharmacology,  therapeutic use
Time Factors
United States
United States Food and Drug Administration
Reg. No./Substance:
0/Anisoles; 0/Anti-Arrhythmia Agents; 0/Potassium Channel Blockers; 0/Pyrrolidines; 0/Sodium Channel Blockers; 0/vernakalant

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