期刊论文详细信息
BMC Research Notes
Meta-analysis of effect of vernakalant on conversion of atrial fibrillation
Zeng Zhiyu1  Ji Lan1  Zhang Zhengnan1  Zhong Guoqiang1  Thi Thi Aung1  He Yan1 
[1] Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi province, China
关键词: Meta-analysis;    Conversion rate;    Sinus rhythm;    Atrial fibrillation;    Vernakalant;   
Others  :  1143295
DOI  :  10.1186/1756-0500-6-94
 received in 2013-01-07, accepted in 2013-01-16,  发布年份 2013
PDF
【 摘 要 】

Background

In recent years, there has been a large amount of studies about the efficacy and safety of vernakalant or RSD1235, an antiarrhythmic agent, in treating the atrial fibrillation (AF). This study was designed to assess the efficacy and safety of vernakalant in the treatment of AF.

Results

A total of 5 randomized controlled trials (RCTs) (n= 1153) met our inclusion criteria. Vernakalant was superior in achieving sinus rhythm (SR) for AF comparing to placebo or alternative anti-arrhythmic agents (relative risk [RR] = 11.56, 95% Confidence Interval [CI] = 7.12 – 18.75). There was no heterogeneity among the trials (X2 =0.59, P = 0.96). In analysing the adverse effects of cardiac origin, there was no significant difference between the two groups (RR= 0.90, 95% CI = 0.52 – 1.57).

Methods

The Cochrane library, Pubmed NCBI, EMBASE and MEDLINE were systematically searched to identify all interventional trials of vernakalant with placebo or other antiarrhythmic drug in converting AF to SR. The primary outcome was rate of converting to SR, and the secondary outcome was the rate of adverse effects of cardiac origin due to vernakalant and the placebo or amiodarone. Meta-analyses were carried out using Mantel-Haenszel fixed-effects or random-effects models and heterogeneity was by the X2 test.

Conclusion

In the conversion of AF to SR, vernakalant is highly effective without obviously raised side effects. Owing to only one study comparing vernakalant with amiodarone included in this study, the efficacy of vernakalant comparing to other antiarrhythmic agents needing more well-designed double-blinded RCTs to be confirmed.

【 授权许可】

   
2013 Yan et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150329040618445.pdf 428KB PDF download
Figure 3. 61KB Image download
Figure 2. 63KB Image download
Figure 1. 74KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]van den Berg MP, van Gelder IC, van Veldhuisen DJ: Impact of atrial fibrillation on mortality in patients with chronic heart failure. Eur J Heart Fail 2002, 4(5):571-575.
  • [2]Wolf PA, Mitchell JB, Baker CS, Kannel WB, D'Agostino RB: Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med 1998, 158(3):229.
  • [3]Kannel WB, Wolf PA, Benjamin EJ, Levy D: Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998, 82(7):2N-9N.
  • [4]Ruigómez A, Johansson S, Wallander MA, Rodríguez LG: Risk of mortality in a cohort of patients newly diagnosed with chronic atrial fibrillation. BMC Cardiovasc Disord 2002, 2(1):5. BioMed Central Full Text
  • [5]Dorian P, Pinter A, Mangat I, Korley V, Cvitkovic SS, Beatch GN: The effect of vernakalant (RSD1235), an investigational antiarrhythmic agent, on atrial electrophysiology in humans. J Cardiovasc Pharmacol 2007, 50(1):35.
  • [6]Fedida D, Orth PMR, Hesketh JC, EZRIN AM: The role of late INa and antiarrhythmic drugs in EAD formation and termination in Purkinje fibers. J Cardiovasc Electrophysiol 2006, 17:S71-S78.
  • [7]Pratt CM, Roy D, Torp-Pedersen C, Wyse DG, Toft E, Juul-Moller S, Retyk E, Drenning DH: Usefulness of vernakalant hydrochloride injection for rapid conversion of atrial fibrillation. Am J Cardiol 2010, 106(9):1277-1283.
  • [8]Roy D, Pratt CM, Torp-Pedersen C, Wyse DG, Toft E, Juul-Moller S, Nielsen T, Rasmussen SL, Stiell IG, Coutu B: Vernakalant hydrochloride for rapid conversion of atrial fibrillation: a phase 3, randomized, placebo-controlled trial. Circulation 2008, 117(12):1518-1525.
  • [9]Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis J, Clarke M, Devereaux P, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009, 62(10):e1-e34.
  • [10]Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996, 17(1):1-12.
  • [11]Camm AJ, Capucci A, Hohnloser SH, Torp-Pedersen C, Van Gelder IC, Mangal B, Beatch G: A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation. J Am Coll Cardiol 2011, 57(3):313-321.
  • [12]Roy D, Rowe BH, Stiell IG, Coutu B, Ip JH, Phaneuf D, Lee J, Vidaillet H, Dickinson G, Grant S: A randomized, controlled trial of RSD1235, a novel anti-arrhythmic agent, in the treatment of recent onset atrial fibrillation. J Am Coll Cardiol 2004, 44(12):2355-2361.
  • [13]Stiell IG, Dickinson G, Butterfield NN, Clement CM, Perry JJ, Vaillancourt C, Calder LA: Vernakalant hydrochloride: A novel atrial-selective agent for the cardioversion of recent-onset atrial fibrillation in the emergency department. Acad Emerg Med 2010, 17(11):1175-1182.
  • [14]Savelieva I, Camm J: Anti-arrhythmic drug therapy for atrial fibrillation: current anti-arrhythmic drugs, investigational agents, and innovative approaches. Europace 2008, 10(6):647-665.
  • [15]Kalus JS: Pharmacologic management of atrial fibrillation: established and emerging options. J Manag Care Pharm 2009, 15(6):S10-18.
  • [16]Kowey P, Roy D, Pratt C, Schwartz P, Dorian P, Mitchell L, Toft E: Efficacy and safety of vernakalant hydrochloride injection for the treatment of atrial fibrillation after valvular or coronary artery bypass surgery. Circulation 2007, 116:7.
  • [17]Cheng JW: Vernakalant in the management of atrial fibrillation. Ann Pharmacother 2008, 42(4):533-542.
  文献评价指标  
  下载次数:38次 浏览次数:19次