Related Experiment Video

Updated: Sep 20, 2026

Transesophageal Atrial Burst Pacing for Atrial Fibrillation Induction in Rats
05:12

Transesophageal Atrial Burst Pacing for Atrial Fibrillation Induction in Rats

Published on: February 14, 2022

Effectiveness of ibutilide in cardioversion of persistent atrial fibrillation in patients with dual chamber

Massimo Santini1, Carlo Pignalberi, Renato Ricci

  • 1Department of Cardiology, S. Filippo Neri Hospital, via Martinotti 20, 00135 Rome, Italy. m.santini@rmnet.it

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|September 17, 2003
PubMed

Insights

Ibutilide effectively converted persistent atrial fibrillation to sinus rhythm in patients with pacemakers. Overdrive ventricular pacing may prevent drug-related arrhythmias, with no adverse effects on pacing thresholds observed.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Persistent atrial fibrillation is a common arrhythmia.
  • Patients with sinus node disease often require pacemakers.
  • Managing atrial fibrillation in pacemaker patients presents unique challenges.

Purpose of the Study:

  • To assess Ibutilide efficacy for cardioversion in pacemaker-dependent patients with persistent atrial fibrillation.
  • To investigate the role of overdrive ventricular pacing in preventing proarrhythmia.
  • To evaluate the safety of Ibutilide in this patient population.

Main Methods:

  • A study involving 53 patients with sinus node disease and dual-chamber pacemakers experiencing persistent atrial fibrillation.
  • Intravenous Ibutilide administration (1-2 mg) with pacing in VVI mode at 90 ppm.
  • Monitoring for 4 hours, with evaluation of pacemaker memory for late arrhythmias and measurement of pacing parameters.

Main Results:

  • Cardioversion to sinus rhythm was achieved in 41.5% of patients.
  • Treatment success correlated with shorter duration of atrial fibrillation.
  • No significant increase in QRS width or adverse effects on pacing thresholds were noted; however, paced QT interval increased.
  • No early or late polymorphic ventricular tachycardia was observed.

Conclusions:

  • Ibutilide demonstrates good effectiveness for persistent atrial fibrillation in pacemaker patients.
  • Overdrive ventricular pacing may mitigate drug-induced proarrhythmia.
  • Ibutilide is safe concerning pacing thresholds in this cohort.
Abstract

More Related Videos

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology10:46

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

Published on: May 26, 2015

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Related Concept Videos

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which indirectly block calcium...
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...