Key result
Intraoperative ibutilide converts persistent AF to sinus rhythm in ~60% of patients failing initial ablation.
Why the study?
The study assessed the efficacy of ibutilide administration during radiofrequency catheter ablation of persistent AF, its conversion success rate and influential factors, and its effects on postoperative recurrence.
Does ibutilide administration improve conversion to normal sinus rhythm and reduce postoperative recurrence in patients with persistent AF failing intraoperative catheter ablation?
Observational (n=192)
No
Does ibutilide administration improve conversion to normal sinus rhythm and reduce postoperative recurrence in patients with persistent AF failing intraoperative catheter ablation?
Ibutilide successfully converts persistent AF to sinus rhythm in about 60% of patients failing intraoperative ablation, but successful conversion does not predict postoperative maintenance of sinus rhythm.
Answers are grounded in this paper and cite their sources.
May facilitate conversion in persistent AF ablation failures; leaves open effects on recurrence and need for randomized trials.
OBJECTIVE To assess the efficacy of ibutilide administration during radiofrequency catheter ablation of persistent atrial fibrillation (AF), to explore the success rate of conversion and related influential factors, and to analyze the effects of ibutilide on postoperative recurrence. METHODS A total of 192 patients with persistent AF who underwent catheter ablation from January 1, 2019, to December 31, 2021. These patients failed in conversion of AF to normal sinus rhythm by intraoperative catheter ablation. Patients were assigned into effective ibutilide (115 patients) and ineffective ibutilide (77 patients) groups. RESULTS The overall success rate of conversion using ibutilide administration was 59.9%. The success rate was associated with the duration of AF (P = 0.008), diameter of left atrium (LAD) (P = 0.002), and N-terminal pro-brain natriuretic peptide (NT-proBNP) level (P = 0.030). The results showed the duration of AF was associated with early recurrence, while early recurrence was not a risk factor for late recurrence. And duration of AF was associated with postoperative maintenance time of normal sinus rhythm, whereas successful conversion into normal sinus rhythm using ibutilide administration had no influence on postoperative maintenance time of normal sinus rhythm. CONCLUSION Ibutilide showed to be effective in catheter ablation of AF, the success rate of conversion was correlated with the duration of AF, LA diameter, and NT-proBNP level. Besides, the duration of AF was found as a risk factor for early postoperative recurrence, while ibutilide administration for successful conversion had no influence on predicting postoperative recurrence and had no influence on postoperative maintenance time of sinus rhythm.
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Li et al. (2023) conducted an observational in Persistent atrial fibrillation (n=192). Ibutilide was evaluated on Success rate of conversion to normal sinus rhythm. Intraoperative administration of ibutilide successfully converted persistent atrial fibrillation to normal sinus rhythm in 59.9% of patients who failed initial catheter ablation.
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