What question did this study set out to answer?

To assess the safety and cardioversion efficacy of intravenous ibutilide in patients with atrial fibrillation or flutter who are receiving long-term oral amiodarone therapy.

January 16, 2001Circulation

Chemical Cardioversion of Atrial Fibrillation or Flutter With Ibutilide in Patients Receiving Amiodarone Therapy

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To assess the safety and cardioversion efficacy of intravenous ibutilide in patients with atrial fibrillation or flutter who are receiving long-term oral amiodarone therapy.
Enrolled 70 patients receiving chronic oral amiodarone (mean duration 153±259 days) undergoing elective cardioversion for atrial fibrillation (n=57, 81%) or atrial flutter (n=13, 19%).
Administered 2 mg intravenous ibutilide, followed by 12-lead ECG monitoring for QT intervals and electrical cardioversion if pharmacological conversion failed within 30 minutes.
Ibutilide achieved conversion within 30 minutes in 39% (22/57) of patients with atrial fibrillation and 54% (7/13) of patients with atrial flutter, while rescue electrical cardioversion converted 90% (35/39) of remaining patients.
Mean QT intervals increased significantly from 371±61 ms to 479±92 ms after ibutilide (P < 0.001), with 1 episode of nonsustained torsade de pointes (1.4%, 1/70).

Structured PICO

Population

70 patients treated with long-term oral amiodarone referred for elective cardioversion of atrial fibrillation (n=57, 81%) or flutter (n=13, 19%). 79% had structural heart disease.

Intervention

2 mg intravenous ibutilide

Outcome

Cardioversion within 30 minutes of infusion

Intravenous ibutilide is an effective and relatively safe method for chemical cardioversion of atrial fibrillation or flutter in patients on long-term amiodarone, with a low risk of torsade de pointes despite QT prolongation.

Discussion

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Implication

Provides preliminary support for ibutilide cardioversion on amiodarone; extends observations but remains hypothesis-generating.

Cite This Study

Glatter et al. (2001) studied this question.

synapsesocial.com/papers/6a702f1d87f92105712783e0 https://doi.org/10.1161/01.cir.103.2.253

Topics

Persistent AF management Atrial fibrillation Echocardiography Anticoagulation in AF

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Chemical Cardioversion of Atrial Fibrillation or Flutter With Ibutilide in Patients Receiving Amiodarone Therapy

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Chemical Cardioversion of Atrial Fibrillation or Flutter With Ibutilide in Patients Receiving Amiodarone Therapy

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider