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Ibutilide: a new class III antiarrhythmic agent

J S Cropp1, E G Antal, R L Talbert

  • 1College of Pharmacy, University of Texas at Austin, USA.

Pharmacotherapy
|January 1, 1997
PubMed
Summary
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Ibutilide fumarate effectively converts atrial flutter (AFl) and atrial fibrillation (AF) to normal sinus rhythm. This antiarrhythmic agent demonstrates superior efficacy compared to sotalol and procainamide in clinical trials.

Area of Science:

  • Pharmacology
  • Cardiology

Background:

  • Ibutilide fumarate is a Class III antiarrhythmic agent.
  • It is approved for converting atrial flutter (AFl) and atrial fibrillation (AF) to normal sinus rhythm.

Purpose of the Study:

  • To evaluate the efficacy and safety of ibutilide fumarate for cardioversion of AFl and AF.
  • To compare ibutilide fumarate with other antiarrhythmic agents like sotalol and procainamide.

Main Methods:

  • Intravenous administration of ibutilide fumarate (1 mg or 0.5-1 mg second dose).
  • Randomized comparative trials against placebo, sotalol, and procainamide.
  • Assessment of conversion rates to normal sinus rhythm and adverse events.

Main Results:

  • Single 1 mg dose converted AFl in 24-58% and AF in 20-32% of patients.

Related Experiment Videos

  • A second dose improved conversion rates to approximately 75% for AFl and 45% for AF.
  • Ibutilide fumarate showed higher efficacy than sotalol and procainamide in converting AFl and AF.
  • Conversion time was typically 20-30 minutes.
  • Nausea was the most common noncardiac adverse effect (<2%).
  • Ventricular tachycardia occurred in 2.7-6.7% (nonsustained) and 1.7% (sustained) of patients.

    • Conclusions:

    • Ibutilide fumarate is an effective intravenous agent for cardioversion of AFl and AF.
    • It offers superior efficacy compared to sotalol and procainamide.
    • The drug is generally well-tolerated, with a low incidence of serious adverse events.