Meta-analysis of effect of vernakalant on conversion of atrial fibrillation

被引：9
作者：
Yan H. [1 ]
Aung T.T. [1 ]
Guoqiang Z. [1 ]
Zhengnan Z. [1 ]
Lan J. [1 ]
Zhiyu Z. [1 ]
机构：
[1] Department of Cardiology, First Affiliated Hospital, Guangxi Medical University, Guangxi province
来源：
BMC Research Notes | / 6卷 / 1期
关键词：
Atrial fibrillation; Conversion rate; Meta-analysis; Sinus rhythm; Vernakalant;
D O I：
10.1186/1756-0500-6-94
中图分类号：
学科分类号：
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 (X§ssup§2§esup§ =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 X§ssup§2§esup§ 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. © 2013 Yan et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 17 条
  • [1] Van Den Berg M.P., Van Gelder I.C., Van Veldhuisen D.J., Impact of atrial fibrillation on mortality in patients with chronic heart failure, European Journal of Heart Failure, 4, 5, pp. 571-575, (2002)
  • [2] Wolf P.A., Mitchell J.B., Baker C.S., Kannel W.B., D'Agostino R.B., Impact of atrial fibrillation on mortality, stroke, and medical costs, Arch Intern Med, 158, 3, (1998)
  • [3] Kannel W.B., Wolf P.A., Benjamin E.J., Levy D., Pritchett E., Reiffel J.A., Olshansky B., Luderitz B., Reiter M., Falk R.H., Camm J., Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: Population-based estimates, American Journal of Cardiology, 82, A8, (1998)
  • [4] Ruigomez A., Johansson S., Wallander M.A., Rodriguez L.G., Risk of mortality in a cohort of patients newly diagnosed with chronic atrial fibrillation, BMC Cardiovasc Disord, 2, 1, (2002)
  • [5] Dorian P., Pinter A., Mangat I., Korley V., Cvitkovic S.S., Beatch G.N., The effect of vernakalant (RSD1235), an investigational antiarrhythmic agent, on atrial electrophysiology in humans, J Cardiovasc Pharmacol, 50, 1, (2007)
  • [6] Fedida D., Orth P.M.R., Hesketh J.C., Ezrin A.M., The role of late INa and antiarrhythmic drugs in EAD formation and termination in Purkinje fibers, J Cardiovasc Electrophysiol, 17, (2006)
  • [7] Pratt C.M., Roy D., Torp-Pedersen C., Wyse D.G., Toft E., Juul-Moller S., Retyk E., Drenning D.H., Usefulness of vernakalant hydrochloride injection for rapid conversion of atrial fibrillation, Am J Cardiol, 106, 9, pp. 1277-1283, (2010)
  • [8] Roy D., Pratt C.M., Torp-Pedersen C., Wyse D.G., Toft E., Juul-Moller S., Nielsen T., Rasmussen S.L., Stiell I.G., Coutu B., Ip J.H., Pritchett E.L.C., Camm A.J., Vernakalant hydrochloride for rapid conversion of atrial fibrillation: A phase 3, randomized, placebo-controlled trial, Circulation, 117, 12, pp. 1518-1525, (2008)
  • [9] Liberati A., Altman D.G., Tetzlaff J., Mulrow C., Gotzsche P.C., 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, 62, 10, (2009)
  • [10] Jadad A.R., Moore R.A., Carroll D., Jenkinson C., Reynolds D.J.M., Gavaghan D.J., McQuay H.J., Assessing the quality of reports of randomized clinical trials: Is blinding necessary?, Controlled Clinical Trials, 17, 1, pp. 1-12, (1996)
12