RAFF4 Trial: Vernakalant vs. Procainamide for Acute Atrial Fibrillation in the Emergency Department
Status:
Recruiting
Trial end date:
2024-06-01
Target enrollment:
Participant gender:
Summary
The objective is to compare IV vernakalant to IV procainamide for the ED management of acute
AF patients. If vernakalant proves to be more effective, faster, and safer than IV
procainamide, this will give clinicians an important alternative for pharmacological
cardioversion of acute AF. The investigators propose a pragmatic comparative effectiveness
trial entailing an open label, randomized controlled trial at 12 large Canadian EDs. Study
subjects will be randomized to 1 of 2 treatment arms: 1) Patients will receive an initial
infusion of 3mg/kg of IV vernakalant over 10 minutes, followed by a second dose of 2mg/kg
over 10 minutes, if necessary, or 2) Patients will receive a continuous infusion of 15mg/kg
of IV procainamide over 60 minutes. The primary aim will be to compare conversion to normal
sinus rhythm between the two drugs. The investigators will include stable patients presenting
with an episode of acute AF of at least 3 hours duration, where symptoms require urgent
management and where immediate cardioversion is a reasonable option. Using the integrated
consent model, research assistants will obtain verbal consent from eligible patients.