604 Long Term Follow-Up of Implantable Loop Recorders: Prolonging Observation Period Increases Diagnostic Yield?

nel blocking properties. We performed a meta-analysis of randomized controlled trials of Vernakalant to examine its efficacy and safety. METHODS: We performed a literature search of MEDLINE, EMBASE and the Cochrane Controlled Trials Register for all randomized trials of Vernakalant versus placebo/anti-arrhythmic (AAD) drug in the acute treatment of recent-onset (3 hours to 45 days) AF. The primary endpoint in all trials was the conversion of AF to sinus rhythm within 90minutes of drug administration. Two independent authors performed the data extraction. Review Manager 5.1 (Cochrane Collaboration) was used to perform the statistical analysis. RESULTS: Five randomized clinical trials (trial acronyms: ACT I, ACT II, ACT III, AVRO, CRAFT) met the inclusion criteria. Four trials compared intravenous Vernakalant to placebo and 1 trial compared intravenous Vernakalant to intravenous Amiodarone (Table 1). A total of 959 patients were included. No significant heterogeneity was found across the trials (I 31%). Conversion to sinus rhythm within 90 minutes occurred in 246 patients out of 573 patients (42.9%) in the Vernakalant group compared to 21 out of 386 patients (5.4%) in the placebo/Amiodarone group. Vernakalant was associated with a significantly higher cardioversion rate compared to the placebo/Amiodarone (relative risk 7.7; CI: 4.5-13.0; P 0.00001). A total of 40 serious adverse events out of 596 patients (6.7%) occurred in the Vernakalant group compared to 33 serious adverse effects out of 396 patients (8.3%) in the placebo/Amiodarone group. CONCLUSION: Vernakalant is effective in the acute conversion of recent-onset AF to sinus rhythm. The drug appears to be welltolerated with no increase in major adverse events compared to placebo/Amiodarone. Table 1.