Vernakalant in recently developed Atrial Fibrillation: How to translate pharmacological trials into clinical practice.

10.5083/ejcm.20424884.105 , Cite or Link Using DOI
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Steen Juul-Möller MD PhD FESC


Objectives: To demonstrate the safety and efficacy of Brinavess® infusion in newly onset Atrial Fibrillation (AF) in a clinical patient setting. Brinavess® has a unique mode of action, since it primarily blocks two potassium channels exclusively found in the atrial myocardium, (The ultra rapid potassium ion channel and the acetylcholine sensitive potassium ion channel).

Background: AF is a common symptomatic disorder in patients seeking acute treatment at the Emergency Room (ER). The treatment is regularly cardioversion using either Direct Current Cardioversion (DCC) or pharmacological conversion. We describe the efficacy of Brinavess® infusion for conversion of Newly onset AF.

Methods: In this cohort registry we have included all patients treated with Brinavess® infusion at the ER at Skåne University Hospital in Malmö. The inclusion period was January 15,2011 to April 15, 2013. We have included all patients treated with Brinavess® and followed them for the inclusion period, 1-27 months.

Results: During the observation period 70% of all 251 patients receiving 351 Brinavess® treatments converted and the conversion occurred after 11 minutes (median). The efficacy was higher in patients with short duration (< 10 h) of the AF-attack, 76%. All patients who have experienced both DCC and Brinavess® infusion were later asked which treatment they prefer. More patients (72%) would prefer Brinavess® infusion compared to 61% DCC (P<0.05). After 1 year follow-up more Brinavess® patients (75%) were still in SR than the DC-cardioverted (45%) (P<0.001). During this period the Brinavess® converted patients had required 1.4 treatments, while the DCC patients (i e the Brinavess®-failures) had needed 1.3 Brinavess® treatments (n.s.) There were no serious adverse events experienced.

Conclusion: The recently introduced Brinavess® infusion for converting newly onset AF has demonstrated to be effective, fast and safe and with very low relapse rate during the first year after treatment in a Real Life cohort analysis.