Vernakalant: A novel antiarrhythmic agent for the treatment of atrial fibrillation
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Dia E.Q., Rathbun R.A., Song J.C.
Vernakalant: A novel antiarrhythmic agent for the treatment of atrial fibrillation
Formulary. 2007 August 1;42:475-483.
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- Abstract
Atrial fibrillation (AF) is a disorder that affects >2 million people in the United States. First-line antiarrhythmic agents (per American College of Cardiology/American Heart Association/ European Society of Cardiology guidelines) that are currently used to treat recent-onset AF work by indiscriminately blocking various ionic channels, thereby inducing a prolonged ventricular action potential duration or possibly inducing ventricular arrhythmias in the presence of myocardial ischemia because of excessive conduction slowing in diseased cardiac tissue. Vernakalant is an atrial-selective, potassium- and sodium-channel-blocking agent awaiting FDA approval for the indication of conversion of recent-onset AF to normal sinus rhythm. This agent offers a novel mechanism of action for the acute conversion of AF, as it specifically targets the potassium channel underlying the ultrarapid delayed rectifier current that is found only in atrial myocytes, along with other potassium channels. Pivotal phase 3 clinical trials have demonstrated that patients with recent-onset AF (≤7 d) who receive intravenous (IV) vernakalant usually convert to normal sinus rhythm within 10 minutes of administration, with response rates of 51% within 90 minutes. Preliminary results from a single phase 3 clinical trial that enrolled patients with recent-onset AF after cardiac surgery demonstrated a conversion rate of 47%. Unlike the commonly used first-line agents, which have been demonstrated to induce polymorphic ventricular arrhythmias, vernakalant appears to be less proarrhythmic, as it has not been demonstrated to induce torsades de pointes. Comparative studies are needed to determine vernakalant's potential role among the agents used in the treatment of AF. (Formulary. 2007;42:475–483.)
DrugBank Data that Cites this Article
- Drugs
- Drug Targets
Drug Target Kind Organism Pharmacological Action Actions Vernakalant Potassium voltage-gated channel subfamily D member 3 Protein Humans YesBlockerDetails Vernakalant Potassium voltage-gated channel subfamily H member 2 Protein Humans UnknownBlockerDetails Vernakalant Sodium channel protein type 5 subunit alpha Protein Humans YesBlockerDetails