ReVeRA-201: Etripamil in Atrial Fibrillation, Phase 2
Atrial Fibrillation

About this trial
This is an interventional treatment trial for Atrial Fibrillation focused on measuring atrial fibrillation, ventricular rate control, rapid ventricular rate, etripamil
Eligibility Criteria
Inclusion Criteria:
A patient will be eligible for study participation if they meet all of the following criteria:
- Aged 18 years and over.
- Has provided written informed consent.
- Patients with episodes of paroxysmal, persistent or permanent AF (Atrial Fibrillation), presenting with AF and a ventricular rate ≥110 bpm, measured over 1 minute
Patients should receive appropriate antithrombotic therapy as per the applicable guidelines for atrial fibrillation management (e.g., Canadian Cardiovascular Society (CCS) guidelines / European Society of Cardiology (ESC) guidelines).
- Etripamil (a calcium channel blocker) is intended for acute rate control only. If rhythm control is desired (outside of the present protocol), anticoagulation as per guidelines may start after the administration of study drug.
Exclusion Criteria:
A patient will be excluded from the study if they meet any of the following criteria:
- Has evidence of atrial flutter (ECG) at presentation.
- Has a history of stroke,Transient Ischemic Attack (TIA) or peripheral embolism within the last 3 months.
- Has received by IV route any of the following within one hour before study drug administration: flecainide, procainamide, digoxin, beta-blocker, or calcium channel blocker.
- Has signs and symptoms of severe congestive heart failure at presentation (e.g. tachypnea, oxygen desaturation <90% unless due to known pulmonary disease, pulmonary rales, sign of peripheral hypoperfusion).
- Hemodynamic instability, with systolic blood pressure <90 mmHg or diastolic blood pressure <60 mmHg.
- Known uncorrected severe aortic or mitral stenosis.
- Hypertrophic cardiomyopathy with outflow tract obstruction.
- Has a history of second- or third-degree atrioventricular block.
- Regular rhythm suggesting a complete Atrioventricular (AV) block.
- Has a history or evidence of torsades de pointes, sick sinus syndrome, or Brugada syndrome.
- Evidence of Acute Coronary Syndrome within the last 12 months except if patient was successfully revascularized.
- Positive pregnancy test result at screening, and females of childbearing potential who do not agree to use adequate method of contraception for the duration of the study.
- Has evidence of any clinically significant acute or chronic condition of the nasal cavity (e.g., rhinitis or deviated septum) which could interfere with administration of the study drug in either or both nasal cavities.
- Has a history of sensitivity to verapamil.
- Has previously participated in a clinical study for etripamil.
- Has a history of sensitivity to any components of the investigational product.
- Signs of alcohol or drug intoxication at the time of presentation which, in the opinion of the Investigator, would impact the validity of study results.
- Is currently participating in another drug or device study, or has received an investigational drug or device within 30 days of Screening.
- Has evidence of clinically significant cardiovascular, endocrine, gastrointestinal, hematologic, hepatic, immunologic, neurologic, oncologic, pulmonary, psychiatric, or renal disease or any other condition which, in the opinion of the Investigator, would jeopardize the safety of the patient or impact the validity of study results.
Sites / Locations
- QEII HSC - Nova Scotia Health Authority
- Hamilton Health Science
- PACE (Partners in Advanced Cardiac Evaluation)
- Ottawa Hospital General & Civic Campus Research Institute
- Institut de Cardiologie de Montreal
- CHU Montréal
- CIUSSS du Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur
- CISSS Bas-Saint-Laurent / Hôpital de Rimouski
- CISSS des Laurentides / Unité de recherche clinique
- CIUSSS de l'Estrie - CHU
- CISSS de Lanaudière - Hôpital Pierre-Le Gardeur
- Jeroen Bosch Ziekenhuis Rijnstate Ziekenhuis
- Jeroen Bosch Ziekenhuis
- Slingeland Ziekenhuis
- Treant Zorggroep
- Elkerliek Ziekenhuis
- Franciscus Gasthuis
- Gelre Ziekenhuizen
Arms of the Study
Arm 1
Arm 2
Placebo Comparator
Experimental
Placebo
Etripamil
Patients will receive a total of 200 μL of placebo ((i.e. 100 μL in each nostril) via the Aptar Pharma Nasal Spray Bidose System. The devices will be prefilled and packaged. Instructions on device usage will be provided.
Patients will receive a total of 200 μL of etripamil Nasal spray 70 mg via the Aptar Pharma Nasal Spray Bidose System. The devices will be prefilled and packaged. Instructions on device usage will be provided.