Why the study?
AF can occur during electrophysiology studies for supraventricular tachycardia induction, complicating ablation, while preferred DCCV may fail and agents like amiodarone alter electrophysiologic analysis.
Does intraprocedural ibutilide allow for successful AVNRT ablation in patients developing spontaneous AF during electrophysiology study?
Does intraprocedural ibutilide allow for successful AVNRT ablation in patients developing spontaneous AF during electrophysiology study?
Intraprocedural ibutilide appears feasible for controlling spontaneous AF during AVNRT ablation without significantly affecting AV nodal properties or inducibility.
Case of recurrent AF during isoprenaline-induced AVNRT ablation suggests non-DCCV options; leaves open prospective validation before practice change.
Atrial fibrillation (AF) is known to occur during electrophysiology studies during the induction of supraventricular tachycardia, especially with isoprenaline. If AF is sustained ablation becomes challenging. DC cardioversion (DCCV) is preferred as medications like amiodarone alters subsequent analysis. We report a 45-year-old female with atrioventricular nodal reentrant tachycardia (AVNRT) (induced with isoprenaline), who developed spontaneous AF, which recurred several times (despite successful DCCV). It was finally controlled with ibutilide. She was taken up after 1 h when AVNRT could be reinduced without any occurrence of AF. The AV nodal property was altered minimally. Radiofrequency ablation could be successfully performed. This is the first report of ibutilide-aided AVNRT ablation, which appears feasible and does not affect inducibility.
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Bera et al. (2022) studied this question.
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