Celivarone for Maintenance of Sinus Rhythm and Conversion of Atrial Fibrillation/Flutter

• Published in: Journal of cardiovascular electrophysiology Vol. 23; no. 5; pp. 462 - 472
• Main Authors: KHITRI, AVINASH R., ALIOT, ETIENNE M., CAPUCCI, ALESSANDRO, CONNOLLY, STUART J., CRIJNS, HARRY, HOHNLOSER, STEFAN H., KULAKOWSKI, PIOTR, ROY, DENIS, RADZIK, DAVID, KOWEY, PETER R.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.05.2012
• Subjects: Aged; amiodarone; Anti-Arrhythmia Agents - administration & dosage; Anti-Arrhythmia Agents - adverse effects; Anti-Arrhythmia Agents - pharmacokinetics; Anti-Arrhythmia Agents - therapeutic use; atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - drug therapy; Atrial Fibrillation - physiopathology; atrial flutter; Atrial Flutter - diagnosis; Atrial Flutter - drug therapy; Atrial Flutter - physiopathology; Benzofurans - administration & dosage; Benzofurans - adverse effects; Benzofurans - pharmacokinetics; Benzofurans - therapeutic use; celivarone; conversion; Dose-Response Relationship, Drug; Double-Blind Method; dronedarone; Drug Administration Schedule; Electrocardiography; Female; Heart Conduction System - drug effects; Heart Conduction System - physiopathology; Humans; Kaplan-Meier Estimate; maintenance; Male; Middle Aged; Predictive Value of Tests; Proportional Hazards Models; Recurrence; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/j.1540-8167.2011.02234.x

Celivarone in Atrial Fibrillation/Atrial Flutter. Introduction: Celivarone, a new noniodinated benzofuran derivative pharmacologically related to dronedarone and amiodarone, has been shown to have antiarrhythmic properties at a molecular level. The purpose of the 2 trials presented here (MAIA and CORYFEE) was to assess celivarone efficacy in the maintenance of sinus rhythm postcardioversion and for the conversion of atrial fibrillation (AF)/atrial flutter (AFL). Methods and Results: In the MAIA trial, 673 patients with AF/AFL recently converted to sinus rhythm were randomly assigned to receive 50, 100, 200, or 300  mg once‐daily dosing of celivarone; 200  mg daily of amiodarone preceded by a loading dose of 600  mg for 10 days; or placebo. At 3 months’ follow up, no significant difference was observed in time to AF/AFL relapse among the various celivarone groups and placebo. However, fewer symptomatic AF/AFL recurrences were observed in the lower‐dose celivarone groups (26.6% for celivarone 50  mg [P  = 0.022] and 25.2% for celivarone 100  mg [P  = 0.018] vs 40.5% for placebo at 90 days). Fewer adverse events were observed with the use of celivarone and placebo than amiodarone. In the CORYFEE study, 150 patients with AF/AFL were randomly assigned to once‐daily celivarone dosing of 300 or 600  mg, or placebo, for a 2‐day treatment period. There was no significant difference in the rate of spontaneous conversion to sinus rhythm between the treatment and control groups. Conclusions: In these studies, celivarone does not appear to be efficacious in the maintenance of sinus rhythm in AF/AFL patients or for the conversion of AF/AFL patients. (J Cardiovasc Electrophysiol, Vol. 23, pp. 462‐472, May 2012)