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Rapid Conversion of Persistent Atrial Fibrillation to Sinus Rhythm by Intravenous AZD7009
Author(s) -
Geller J. Christoph,
Egstrup Kenneth,
Kulakowski Piotr,
Rosenqvist Mårten,
Jansson Maria Aunes,
Berggren Anders,
Edvardsson Nils,
Sager Philip,
Crijns Harry J.
Publication year - 2009
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270008329549
Subject(s) - atrial fibrillation , sinus rhythm , medicine , cardiology , anesthesia
This randomized, double‐blind trial compared cardioversion rates between AZD7009 infusion (15‐minute 3.25 mg/min, 15‐minute 4.4 mg/min, or 30‐minute 3.25 mg/min) and placebo infusion (15 or 30 minutes) in patients with atrial fibrillation (AF) scheduled for DC cardioversion. One hundred sixty‐eight patients were randomized, 167 received study treatment, and 159 were included in per‐protocol analyses. The mean duration of current AF episode was 47 days (range, 0.8–92). In the AZD7009 30‐minute 3.25 mg/min group, 21 of 42 patients converted within 90 minutes, compared with 7 of 39, 7 of 36, and 0 of 42 patients in the 15‐minute 3.25 mg/min, 15‐minute 4.4 mg/min, and combined placebo groups, respectively. Patients not converted within 90 minutes underwent DC cardioversion. In patients with AF episodes ≤30 days, conversion rates with AZD7009 30‐minute 3.25 mg/min and after placebo followed by DC cardioversion were 82% and 83%, respectively. AZD7009 was generally well tolerated. Mean QTc increased by 15% to 20% in the AZD7009 treatment groups. One patient experienced a ventricular tachyarrhythmia of 7 beats, with features of torsades de pointes. AZD7009 was associated with a 50% conversion rate in the best‐dose group. In patients with AF episodes ≤30 days, the conversion rates after AZD1305 and placebo followed by DC cardioversion were observed to be similar.