New study finds faster relief for patients with acute atrial fibrillation
Imagine being a patient with acute atrial fibrillation (AF) in an emergency department at a hospital. Heart pounding with irregular palpitations, a marked weakness throughout the body, simple tasks feeling impossible — relief must be around the corner, but how soon can it get here?
A clinical trial recently published in The BMJ found that a newer drug called vernakalant reduces AF symptoms faster than with the more commonly used procainamide. While both drugs can restore a regular heart rhythm, patients treated with vernakalant had a steady heart rate in an average of 22 minutes compared to 44 minutes for procainamide. Patients treated with procainamide were also more likely to need electrical cardioversion, by a controlled shock from defibrillator.
The randomized trial, led by The Ottawa Hospital, enrolled 350 patients across 12 Canadian emergency departments. The study also found that vernakalant was even more effective for patients under 70 years old (73 per cent returning to normal heart rates vs 47 per cent for procainamide).
“For patients in acute atrial fibrillation, rapid treatment improves care,” says Dr. Ian Stiell. “Our goal is to get them back to a regular heart rate and back to their homes as soon as possible.”
“For patients in acute atrial fibrillation, rapid treatment improves care,” says Dr. Ian Stiell, lead author of the paper and an emergency physician and senior scientist at The Ottawa Hospital and distinguished professor at the University of Ottawa. “Our goal is to get them back to a regular heart rate and back to their homes as soon as possible. Treatment with vernakalant not only helps patients, but it also helps our emergency departments free up beds and staff sooner.”
The team’s next step is a broader cost-effectiveness analysis comparing vernakalant and procainamide, which are both administered intravenously.
Authors:
Ian G Stiell, Monica Taljaard, Debra Eagles, Krishan Yadav, Alain Vadeboncoeur, Corinne M Hohl, Patrick M Archambault, David Birnie, Erica Brown, Samuel G Campbell, Yutong Chen, Catherine M Clement, Alexis Cournoyer, Kerstin de Wit, Marcel Emond, Laurent Macle, Andrew D McRae, Eric Mercier, Judy Morris, Ghadeer Mohamad, Marie-Joe Nemnom, Stuart G Nicholls, David Pare, Ratika Parkash, Marco LA Sivilotti, Kednapa Thavorn, Jeffrey J Perry
Funding:
Canadian Institutes of Health Research, the Accelerating Clinical Trials (ACT) Consortium (Canada) and Cipher Pharmaceuticals (Canada) (unrestricted grant)
Core Facilities:
Learn more about:
The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa and supported by The Ottawa Hospital Foundation.
