Acute beta-adrenoceptor blockade improves efficacy of ibutilide in conversion of atrial fibrillation with a rapid ventricular rate
Why the study?
Does esmolol combined with ibutilide improve conversion to sinus rhythm in patients with rapidly conducting atrial fibrillation?
Population
90 patients with rapidly conducting atrial fibrillation, mean age 63 +/- 13.5 years.
Comparison
Esmolol titrated to achieve a heart rate of <100… vs Ibutilide monotherapy
Design
RCT, Randomized in to two groups
Follow-up
Acute (at the time of conversion)
Authors
Discussion
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Member takes
Implication
Supports esmolol addition to ibutilide for cardioversion in rapid AF; confirms adjunctive benefit in this RCT.
Structured PICO
Does esmolol combined with ibutilide improve conversion to sinus rhythm in patients with rapidly conducting atrial fibrillation?
P
Population
90 patients with rapidly conducting atrial fibrillation (AF with a rapid ventricular rate), mean age 63 +/- 13.5 years.
I
Intervention
Esmolol titrated to achieve a heart rate of <100 bpm followed by ibutilide co-administration
C
Comparator
Ibutilide monotherapy
O
Outcome
Conversion to sinus rhythm (SR)surrogate
The addition of esmolol to ibutilide improves the efficacy of cardioversion to sinus rhythm in patients with rapidly conducting atrial fibrillation while reducing QTc prolongation and VT risk, though with increased bradycardia.
Cite This Study
Fragakis et al. (2008) studied this question.