Emerging treatments
Vernakalant
Intravenous vernakalant has demonstrated superior efficacy to amiodarone or placebo for acute conversion of recent-onset AF. Intravenous vernakalant was no different in efficacy at rhythm conversion to ibutilide.[152][153] Oral vernakalant appears to be effective in preventing AF recurrence post-cardioversion.[154] While some studies suggest there is no significant difference in the safety of vernakalant compared with other drugs used for pharmacologic cardioversion of AF, further research is needed to clarify its safety profile.[155][156] Oral vernakalant is not currently available in the US.
Colchicine
Inflammation is implicated in AF pathophysiology and stroke risk in anticoagulated patients, so studies are looking at treatments targeting inflammation to reduce markers of inflammation and thrombosis in patients with AF.[11] Data from randomized control trials suggests that treatment with colchicine may reduce adverse cardiovascular outcomes in patients with established cardiovascular disease, as well as potentially being effective for preventing early recurrences of AF after catheter ablation.[11] In the context of postoperative prophylaxis of AF following cardiac surgery, data supporting use of colchicine have not been found to be robust.[43]
Factor XI inhibitors
Factor XI has been identified as a promising target for safer anticoagulants, having significant affinity for thrombotic mechanisms, but a limited role in hemostasis.[11]
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