Key result
Intravenous ibutilide successfully cardioverted 94% of patients with paroxysmal AF during SVT ablation compared to 100% with DC electrical cardioversion, with no significant difference in efficacy.
Why the study?
Does intravenous ibutilide safely and effectively cardiovert paroxysmal atrial fibrillation during radiofrequency ablation of supraventricular tachycardias compared to direct current electrical cardioversion?
RCT (n=34)
Does intravenous ibutilide safely and effectively cardiovert paroxysmal atrial fibrillation during radiofrequency ablation of supraventricular tachycardias compared to direct current electrical cardioversion?
Intravenous ibutilide is a safe and effective alternative to direct current electrical cardioversion for restoring sinus rhythm in patients who develop paroxysmal atrial fibrillation during SVT ablation.
Ibutilide offers a viable alternative to DC cardioversion during SVT ablation; extends pharmacological options for periprocedural AF management.
Direct current electrical cardioversion (DC-ECV) is the preferred treatment for the termination of paroxysmal atrial fibrillation (AF) that occurs during radiofrequency ablation (RFA) of supraventricular tachycardias (SVT). Intravenous Ibutilide may be an alternative option in this setting. Thirty-four out of 386 patients who underwent SVT-RFA presented paroxysmal AF during the procedure and were randomized into receiving ibutilide or DC-ECV. Ibutilide infusion successfully cardioverted 16 out of 17 patients (94%) within 17.37 ± 7.87 min. DC-ECV was successful in all patients (100%) within 17.29 ± 3.04 min. Efficacy and total time to cardioversion did not differ between the study groups. No adverse events were observed. RFA was successfully performed in 16 patients (94%) in the ibutilide arm and in all patients (100%) in the DC-ECV arm, p = NS. In conclusion, ibutilide is a safe and effective alternative treatment for restoring sinus rhythm in cases of paroxysmal AF complicating SVT-RFA.
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Polymeropoulos et al. (2011) conducted an RCT in Paroxysmal atrial fibrillation during radiofrequency ablation of supraventricular tachycardias (n=34). Intravenous Ibutilide vs. Direct current electrical cardioversion (DC-ECV) was evaluated on Successful cardioversion. Intravenous ibutilide successfully cardioverted 94% of patients with paroxysmal AF during SVT ablation compared to 100% with DC electrical cardioversion, with no significant difference in efficacy.
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