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Vernakalant hydrochloride for the treatment of atrial fibrillation: evaluation of its place in clinical practice

    Leona A Ritchie‡

    Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart & Chest Hospital, Liverpool, L7 8TX, UK

    ‡Authors contributed equally

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    ,
    Shuguang Qin‡

    Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart & Chest Hospital, Liverpool, L7 8TX, UK

    Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University, Xi'an 710004, China

    ‡Authors contributed equally

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    ,
    Peter E Penson

    Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart & Chest Hospital, Liverpool, L7 8TX, UK

    School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK

    ,
    Neil C Henney

    School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK

    &
    Gregory YH Lip

    *Author for correspondence:

    E-mail Address: Gregory.Lip@liverpool.ac.uk

    Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart & Chest Hospital, Liverpool, L7 8TX, UK

    Published Online:https://doi.org/10.2217/fca-2020-0039

    Vernakalant is an intravenous anti-arrhythmic drug available in Europe, Canada and some countries in Asia for the restoration of sinus rhythm in acute onset atrial fibrillation. Currently, it is not available in USA because the US FDA have ongoing concerns about its safety. Vernakalant has a unique pharmacological profile of multi-ion channel activity and atrial-specificity that distinguishes it from other anti-arrhythmic drugs. This is thought to enhance efficacy but there are concerns of adverse events stemming from its diverse pharmacology. This ambiguity has prompted a review of the available clinical evidence on efficacy and safety to help re-evaluate its place in clinical practice.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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