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Related Experiment Videos

Ibutilide in persistent atrial fibrillation refractory to conventional cardioversion methods.

Barbara Naegeli1, Edwin Straumann, Osmund Bertel

  • 1Cardiac Unit, Department of Internal Medicine, Stadtspital Triemli, Birmensdorferstr. 497, CH-8063 Zürich, Switzerland. Barbara.Naegeli@triemli.stzh.ch

International Journal of Cardiology
|March 8, 2005
PubMed
Summary

Ibutilide combined with electrical cardioversion successfully restored normal heart rhythm in 95% of patients with persistent atrial fibrillation resistant to other treatments. This combined strategy proved safe and effective for difficult-to-treat atrial fibrillation cases.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Persistent atrial fibrillation (AF) poses treatment challenges, especially when refractory to standard therapies.
  • Electrical cardioversion efficacy in AF can be enhanced by ibutilide, but its use in treatment-resistant cases is less understood.

Purpose of the Study:

  • To assess the efficacy and safety of ibutilide in patients with persistent AF unresponsive to prior antiarrhythmic drugs and electrical cardioversion.
  • To evaluate ibutilide's role in patients with long-standing, difficult-to-convert AF.

Main Methods:

  • A prospective study involving 22 patients with structural heart disease and persistent AF (mean duration 39 months).
  • Patients had previously failed transthoracic cardioversion while on Class III antiarrhythmics (amiodarone or sotalol).

Related Experiment Videos

  • Ibutilide (1 mg) was administered, followed by repeat electrical cardioversion if needed.

    • Main Results:

    • A 95% overall conversion rate to sinus rhythm was achieved.
    • 2% converted with ibutilide alone; 86% converted with ibutilide plus repeat electrical cardioversion.
    • No adverse effects were reported; QTc interval prolongation was observed (451 to 491 ms).
    • 64% of patients remained free from AF at 1-month follow-up.

    Conclusions:

    • Concomitant ibutilide infusion and electrical cardioversion achieved a 95% success rate in restoring sinus rhythm for persistent AF refractory to conventional methods.
    • This combined approach is safe and effective, offering an alternative for patients with AF resistant to standard cardioversion.
    • The strategy demonstrates significant success in managing long-term persistent atrial fibrillation previously unresponsive to treatment.