Pharmacotherapy Options in Atrial Fibrillation: Focus on Vernakalant

This article reviews the role of vernakalant in the management of atrial fi brillation (AF). Published data in English language were identifi ed from MEDLINE and Current Content database (both 1966 to January 30, 2009). Vernakalant is an antiarrhythmic agent with sodium and ultra-rapid potassium channel blockage property and atrial selective effect. In clinical studies evaluating intravenous vernakalant in cardioversion of patients with recent onset AF, vernakalant improve the chance of acute restoration to normal sinus rhythm (NSR). In post-operative AF, the chance of conversion to NSR was also improved. Phase II studies demonstrated that oral vernakalant 300 mg or 600 mg twice daily successfully maintained normal sinus rhythm compared to placebo. Common side effects include dysgeusia, sneezing, and paresthesia. Future studies are needed to explore the effi cacy and safety of using vernakalant with patient populations who are prone to AF, as well as its comparative effi cacy and safety to other antiarrhythmic agents. Introductionfi brillation (AF) is a common type of atrial arrhythmia and chronic AF doubles the risk of total and cardiovascular mortality. Risk of AF increases with age with an incidence up to 26.0% for men and 23.0% for women by the age of 40. 1 In patients undergoing cardiothoracic surgery, the risk of AF