Vernakalant: Review of a Novel Atrial Selective Antiarrhythmic Agent and its Place in Current Treatment of Atrial Fibrillation

Abstract

Atrial fibrillation (AF) remains the most common arrhythmia requiring treatment in the emergency department and is the cause of major morbidity and considerable financial burden. Choosing the appropriate therapy to treat recent-onset AF can be extremely demanding and problematic and recent efforts have been focused on identification of an intravenous antiarrhythmic drug that can provide rapid, effective and safe cardioversion of an acute episode. While the currently available antiarrhythmics show moderate efficacy and pose a risk for serious ventricular proarrhythmias, vernakalant, a recently developed multi-channel inhibitor, has consistently proved to be both effective and safe in converting recent-onset AF to sinus rhythm in randomized clinical trials. Its relatively high atrial selectivity preventing potentially lethal episodes of torsades de pointes as well as its prompt onset of action, offer intravenous vernakalant a strong advantage over its competitors and constitutes an attractive option for the physician.