Rapid Slowing of the Atrial Fibrillatory Rate After Administration of AZD7009 Predicts Conversion of Atrial Fibrillation

J Electrocardiol. May-Jun 2014;47(3):316-23. doi: 10.1016/j.jelectrocard.2013.12.008. Epub 2013 Dec 18.

Abstract

Background: Effects on the atrial fibrillatory rate (AFR) were studied during infusion with the combined potassium and sodium channel blocker AZD7009.

Methods and results: Patients with persistent atrial fibrillation (AF) were randomized to AZD7009 or placebo. Thirty-five patients converted to sinus rhythm (SR) and were matched to 35 non-converters. The mean AFR before conversion was 231 fibrillations per minute (fpm), having decreased by 41%; in non-converters, it was 296 fpm at the end of infusion, having decreased by 26%. The rate of decrease was greater in converters at 5 min, -88 vs. -66 fpm (p=0.02), and at 10 min, -133 vs. -111 fpm (p=0.048). The AFR-SD and the exponential decay decreased. A small left atrial area was the only baseline predictor of conversion to SR.

Conclusions: AZD7009 produced a significantly more rapid decrease of the AFR in converters than in non-converters, but the AFR at baseline was not predictive of conversion.

Keywords: AZD7009; Atrial fibrillation; Atrial fibrillatory rate; Conversion.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Arrhythmia Agents / administration & dosage
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / physiopathology
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Electrocardiography / drug effects*
  • Electrocardiography / methods
  • Female
  • Heart Rate / radiation effects*
  • Humans
  • Male
  • Middle Aged
  • Organic Chemicals / administration & dosage*
  • Placebo Effect
  • Prognosis
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Young Adult

Substances

  • AZD 7009
  • Anti-Arrhythmia Agents
  • Organic Chemicals