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Predictors of conversion of recent-onset atrial fibrillation treated with vernakalant


Pacing Clin Electrophysiol. 2015 Feb;38(2):196-200.

Predictors of conversion of recent-onset atrial fibrillation treated with vernakalant.

Costabel JP1Lambardi FAragón MCampos RUrdapilleta MAriznavarreta PVergara JMConde D.

BACKGROUND:

Vernakalant is an available drug for the treatment of recent-onset atrial fibrillation, producing conversion between 55% and 87% of the patients treated. In this sense, little is known about the predictors of conversion with this agent. The aim of our study was to analyze thepredictors of conversion in our 2-year experience using vernakalant for the treatment of recent-onset atrial fibrillation.

METHODS:

One hundred twenty-one patients with recent-onset atrial fibrillation without hemodynamic impairment received pharmacological treatment with vernakalant. Clinical variables, history of cardiovascular diseases, and echocardiographic data were recorded.

RESULTS:

Mean age was 58.1 ± 13.9 years and 13.4% of patients had structural heart disease. Conversion to sinus rhythm was achieved in 84.5% of patients, and 46% required the second dose of vernakalant. After analyzing the predictors of conversion, the presence of structural heart disease was significantly larger in the group without conversion (35.3 vs 9.7%; P = 0.02). The mean ejection fraction in the group with conversion was 61.05 ± 5.7% versus 54.9 ± 8.4% in the group without conversion (P = 0.016). After dichotomizing the variable ejection fraction, patients with ejection fraction <55% had a lower conversion rate (P = 0.001).

CONCLUSION:

In our study, the absence of any kind of structural heart disease and preserved systolic function were associated with greaterconversion rate with vernakalant.

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