Table 1.
New antiarrhythmic drugs and new formulations of existing antiarrhythmic drugs in development
| Novel antiarrhythmic agents | ||||
|---|---|---|---|---|
| Agent (developer) | Main antiarrhythmic target | Indication | Formulation | Current clinical status |
| AP30663 | Small conductance calcium-activated potassium (SK) channel blocker | Cardioversion of recent-onset AF | Intravenous | Phase 2 completed (NCT04571385) |
| AP31969 | Small conductance calcium-activated potassium (SK) channel blocker | Sinus rhythm maintenance | Oral | Phase 1 ongoing |
| HSY244 | Undisclosed | Cardioversion of recent-onset AF | Intravenous | Phase 2 terminated (business decision) (NCT04582409) |
| HBI-3000 (sulcardine) |
Multi-channel blocker | Cardioversion of recent-onset AF (>2 and <72 h) | Intravenous | Phase 2 ongoing (NCT04680026) |
| Budiodarone | Multi-channel blocker | Sinus rhythm maintenance | Oral | Phase 2 completed (PASCAL) |
| Botulinum toxin A | Cholinergic neurotransmission blocker | Prevention of postoperative AF | Injection around ganglionated plexuses | Phase 2 (NCT01842529; NOVA) |
| Reformulation of already approved AADs | ||||
|---|---|---|---|---|
| Antiarrhythmic drug | Main antiarrhythmic target | Indication | Reformulation | Current clinical status |
| Flecainide | Sodium channel blocker | Cardioversion of recent-onset symptomatic AF | Inhalation solution | Phase 2 terminated (NCT05039359; RESTORE-1) Phase 3 currently on hold (NCT03539302; INSTANT) |
| Repurposing of already approved medications | ||||
|---|---|---|---|---|
| Agent (developer) | Main antiarrhythmic target | Indication | Formulation | Current clinical status |
| Bucindolol | Beta 1 adrenergic blockade and receptor reduction | Sinus rhythm maintenance | Oral | Phase 2 completed (NCT01970501; GENETIC-AF) |
| Doxapram | TASK 1 inhibitor | Cardioversion of recent-onset AF | Intravenous | Phase 2 ongoing (EudraCT 2018-002979-17; DOCTOS) |
| Ranolazine | Late sodium channel blocker with minor effect on HERG channel | Sinus rhythm maintenance following cardioversion Reduction in AF burden in paroxysmal AF: Ranolazine and dronedarone given alone and in combination |
Oral Oral |
Phase 2 completed (NCT01534962; RAFFAELLO) Phase 2 completed (NCT01522651) |
Published results of completed studies are explained in more details, including references, in the text.