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Clinical and cost comparison of ibutilide and direct-current cardioversion for atrial fibrillation and flutter
D K Murdock1, G T Schumock, J Kaliebe
1Cardiovascular Associates of Northern Wisconsin, Wausau, USA.
Insights
Direct-current cardioversion is more effective and cost-efficient for restoring normal heart rhythm in recent-onset atrial fibrillation or flutter compared to intravenous ibutilide treatment. This study highlights DC cardioversion as the preferred clinical strategy.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacoeconomics
Background:
- Atrial fibrillation and flutter are common arrhythmias.
- Restoring sinus rhythm is a key treatment goal.
- Anticoagulation is crucial before rhythm conversion.
Purpose of the Study:
- To compare the clinical effectiveness of intravenous ibutilide versus direct-current cardioversion.
- To evaluate the cost-effectiveness of each method for recent-onset atrial fibrillation/flutter.
- To determine the optimal strategy for sinus rhythm restoration.
Main Methods:
- Prospective comparison of two treatment strategies.
- Inclusion of patients with recent-onset atrial fibrillation or flutter.
- Assessment of success rates and healthcare costs.
Main Results:
- Intravenous ibutilide demonstrated a low success rate for rhythm conversion.
- Direct-current cardioversion achieved higher success rates.
- Direct-current cardioversion was found to be more cost-effective.
Conclusions:
- Direct-current cardioversion is the preferred method for restoring sinus rhythm.
- Ibutilide is less effective and less cost-efficient for this indication.
- Clinical guidelines should favor direct-current cardioversion for recent-onset arrhythmias.
Abstract:
The clinical effectiveness and cost to convert recent-onset atrial fibrillation or flutter to sinus after 3 to 4 weeks of anticoagulation with intravenous ibutilide was compared with direct-current cardioversion. The low success rate with ibutilide made direct-current cardioversion the more clinical and cost-effective method to restore sinus rhythm.