{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:49:42Z","timestamp":1783608582772,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Currently, there are no available fast\u2010acting agents to control the ventricular rate (VR) during atrial fibrillation (AF) episodes that can be self\u2010administered by patients on an as\u2010needed basis without medical supervision. Here, we aim to evaluate the effect of intranasal etripamil on VR in patients treating presumed paroxysmal supraventricular tachycardia (PSVT) episodes later identified as AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>NODE\u2010303 is a phase 3, multicenter, open\u2010label study to evaluate the safety and efficacy of self\u2010administered intranasal etripamil. The study enrolled adult (\u2265\u200918 years) patients with prior documented PSVT. Patients self\u2010administered 70\u2009mg of intranasal etripamil after applying an ECG monitor and performing a vagal maneuver. An optional second 70\u2009mg dose was permitted if symptoms persisted after 10\u2009min. This post hoc analysis specifically focused on AF patients (those with presumed PSVT episodes subsequently identified as AF) and evaluated the change from baseline VR (beats per minute, bpm), calculated using patient ECG data that was recorded through 60\u2009min after drug administration, during an etripamil\u2010treated AF episode.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1116 total enrolled patients, 503 self\u2010administered \u2265\u20091 dose of etripamil for presumed PSVT, and 18 had \u2265\u20091 episode(s) later identified as AF with adequate ECG data. AF episode baseline median VR (range) was 127\u2009bpm (79, 164), and the average maximum reduction in VR was 27.4 bpm \u00b1\u20096.1 at 22\u2009min. VR reduction was sustained for at least 30 to 60\u2009min (median VR reduction \u221222 and \u221218\u2009bpm, respectively). No serious adverse events or adverse events of special interest were observed, including bradyarrhythmias, AV block, or sinus pauses \u2265\u20093\u2009s, and treatment\u2010emergent adverse events were mild to moderate, transient, and related to the nasal administration route.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this post hoc subgroup analysis of the open\u2010label NODE\u2010303 trial, self\u2010administered etripamil nasal spray led to a clinically significant and sustained VR reduction in patients with symptomatic AF. Further studies are needed to confirm efficacy in a broader AF population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Self\u2010administered etripamil may help to acutely control symptomatic AF\u2010RVR episodes outside of the healthcare setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>NCT04072835.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70287","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T07:45:09Z","timestamp":1770795909000},"page":"859-863","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Self\u2010Administered Etripamil Nasal Spray Slows Ventricular Rate in Patients With Atrial Fibrillation: A Post Hoc Analysis of the NODE\u2010303 Study"],"prefix":"10.1111","volume":"37","author":[{"given":"Paul","family":"Dorian","sequence":"first","affiliation":[{"name":"Division of Cardiology, St. Michael's Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Alings","sequence":"additional","affiliation":[{"name":"Amphia Ziekenhuis Breda North Brabant Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Coutu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Montreal; Cardiac Electrophysiology Department Centre Hospitalier Universitaire de Montr\u00e9al Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3461-505X","authenticated-orcid":false,"given":"James E.","family":"Ip","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Weill Cornell Medicine, New York Presbyterian Hospital New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe A.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Universidad Nacional de C\u00f3rdoba; Instituto DAMIC\/Fundacion Rusculleda C\u00f3rdoba Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Piccini","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce S.","family":"Stambler","sequence":"additional","affiliation":[{"name":"Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Milestone Pharmaceuticals Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Shardonofsky","sequence":"additional","affiliation":[{"name":"Milestone Pharmaceuticals Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Bharucha","sequence":"additional","affiliation":[{"name":"Milestone Pharmaceuticals Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. John","family":"Camm","sequence":"additional","affiliation":[{"name":"St. George's University of London London England UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcaa061"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1747493019897870"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009024"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.011"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.099903"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpdd.1383"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00776-6"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.123.011681"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2025.0417"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.03.384"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.70086"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2024.01.007"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.123.012567"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70287","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:02:31Z","timestamp":1780495351000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/jce.70287"],"URL":"https:\/\/doi.org\/10.1111\/jce.70287","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]},"assertion":[{"value":"2025-10-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}