Current experience and new prospects for the use of the antiarrhythmic drug — cavutilide

Current experience and new prospects for the use of the antiarrhythmic drug — cavutilide

Yu.A. Yuricheva, N.Yu. Mironov, Kh.M. Dzaurova, S.F. Sokolov, S.P. Golitsyn, V.V. Vlodzyanovskiy, M.M. Belyaeva, E.B. Maykov, D.A. Gagloeva, M.A. Zelberg 

National Medical Research Centre of Cardiology Named After Academician E.I. Chazov, Moscow 

Over the last years, class III antiarrhythmic drugs have been the focus of study researches. Their effect is opposite to the processes occurring during electrical remodeling in atrial fibrillation (AF), namely, shortening of their effective refractory period. Cavutilide is a domestic class III antiarrhythmic drug. The review presents the results of preclinical and clinical studies of cavutilide. The results of clinical trials and post-marketing studies have proved that it is comparable in efficacy with electrical cardioversion and significantly surpasses all available antiarrhythmic drugs in efficacy (more than 90%) in relieving both AF and atrial flutter (AFL) of any duration and in various clinical cases. It is also capable of interrupting the course of paroxysmal supraventricular tachycardia. Cavutilide is well tolerated. The risk of proarrhythmic effects is low, the incidence of polymorphic ventricular tachycardia Torsade de pointes, mainly unstable episodes, is 1.5 — 2%. A drug tablet form has been created and is being prepared for introduction. Phase I results of its clinical trials, which described the drug pharmacokinetics, determined its dosage regimen, confirmed its use safety and served as the basis of the phase II clinical trial protocol in patients with persistent AF/AFL after sinus rhythm restoration.

Keywords: class III antiarrhythmic drug, cavutilide, pharmacological cardioversion, atrial fibrillation, atrial flutter, QT interval, Torsade de pointes.

For citation: Yuricheva Yu.A., Mironov N.Yu., Dzaurova Kh.M., Sokolov S.F., Golitsyn S.P., Vlodzyanovskiy V.V., Belyaeva M.M., Maykov E.B., Gagloeva D.A., Zelberg M.A. Current experience and new prospects for the use of the antiarrhythmic drug — cavutilide. RMJ. 2023;9:40–46.