CoChat
Sign Up
Cited by 156Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasAtrial Fibrillation Management and Outcomes

The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.

Antiarrhythmic Actions of Intravenous Ibutilide Compared With Procainamide During Human Atrial Flutter and Fibrillation: Electrophysiological Determinants of Enhanced Conversion Efficacy

Stambler, Bruce S., Wood, Mark A., Ellenbogen, Kenneth A.·1997·Circulation
DOI 10.1161/01.cir.96.12.4298
Open this paper in CoChat — free account

Abstract

BACKGROUND: The selective class III antiarrhythmic agent ibutilide prolongs action potential duration and terminates atrial flutter (AFL) and fibrillation (AF), but the mechanism of its antiarrhythmic efficacy in humans has not been fully characterized. This study compared the antiarrhythmic effects of ibutilide with the class IA agent procainamide in humans during AFL and AF. Antiarrhythmic drug actions and electrophysiological characteristics of AFL and AF that enhanced pharmacological termination were investigated. METHODS AND RESULTS: Right atrial monophasic action potentials were recorded during 148 episodes of AFL (n=89) or AF (n=59) in 136 patients treated with intravenous ibutilide (n=73) or placebo (n=22) as participants in randomized, double-blinded comparative studies or intravenous procainamide (n=53) in a concurrent open-label study. The conversion rates in AFL with ibutilide, procainamide, and placebo were 64% (29 of 45 patients), 0% (0 of 33), and 0% (0 of 11), respectively, whereas in AF the rates were 32% (9 of 28), 5% (1 of 20), and 0% (0 of 11), respectively. In AFL, ibutilide increased atrial monophasic action potential duration (MAPD) more (30% versus 18%, P<.001) and prolonged atrial cycle length (CL) less (16% versus 26%, P<.001) than procainamide. Ibutilide shortened and procainamide prolonged action potential diastolic interval during AFL (-12% versus 51%, P<.001). Ibutilide increased MAPD/CL ratio, whereas procainamide tended to decrease this ratio (13% versus -6%, P<.01). In AF, ibutilide and procainamide induced similar increases in atrial CL (48% versus 45%), but ibutilide induced a greater increase in MAPD (52% versus 37%, P<.05). Independent electrophysiological predictors of pharmacological arrhythmia termination were increase in MAPD/CL ratio (P=.005) in AFL and longer baseline mean MAPD (P=.011) in AF. Termination of AFL with ibutilide was characterized by significant increases in beat-to-beat atrial CL, MAPD, and diastolic interval variability. Ibutilide was significantly more effective in converting AF when the mean atrial CL was > or = 160 ms (64% versus 0%, P<.001) or MAPD was > or = 125 ms (57% versus 0%, P=.002) at baseline. CONCLUSIONS: Enhanced conversion efficacy of ibutilide compared with procainamide in AFL is correlated with a relatively greater prolongation of atrial MAPD than atrial CL, and termination of AFL by ibutilide is characterized by oscillations in atrial CL and MAPD. Conversion of AF by ibutilide is enhanced by a longer baseline mean atrial CL or MAPD.

Overview

Integrity signals

Registry

Crossref · 10.1161/01.cir.96.12.4298

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Research works printed but not linked: 13

  1. 10.1161/circ.74.1.3708774 · DOI
  2. 10.1161/circ.76.6.2445503 · DOI
  3. 10.1161/res.65.6.2510953 · DOI
  4. 10.1161/res.68.4.2009611 · DOI
  5. 10.1161/res.71.2.1628386 · DOI
  6. Feld GK. Pharmacological control of experimental atrial arrhythmias: significance of prolonging excitation wavelength. In: Singh BN Wellens HJJ Hiraoka M eds. Electropharmacological Control of Cardiac Arrhythmias to Delay Conduction or to Prolong Refractoriness? Mount Kisco NY: Futura Publishing Co; 1994:265-277.
  7. Allessie MA. Reentrant mechanisms underlying atrial fibrillation. In: Zipes DP Jalife J eds. Electrophysiology: From Cell to Bedside. 2nd ed. Philadelphia Pa: WB Saunders Co; 1995:562-566.
  8. 10.1161/circ.94.7.1613 · DOI
  9. Volgman AS, Stambler BS, Kappagoda C, Carberry PA, Dunn GH, Perry KT, VanderLugt JT, Kowey PR. Comparison of intravenous ibutilide versus procainamide for the rapid termination of atrial fibrillation or flutter. PACE. 1996;19:608. Abstract.
  10. 10.1161/circ.46.3.528 · DOI
  11. Lammers WJEP, Allessie MA, Rensma PL. The use of fibrillation cycle length to determine spatial dispersion in electrophysiological properties and to characterize the underlying mechanisms of fibrillation. New Trends Arrhythmias. 1986;2:109-112.
  12. Moe GK. On the multiple wavelet hypothesis of atrial fibrillation. Arch Int Pharmacodyn Ther. 1962;140:183-188.
  13. Buchanan LV, LeMay RJ, Gibson JK. Comparison of the class III agents d,l-sotalol HCl and ibutilide fumarate for atrial reverse use dependence and antiarrhythmic effects. PACE. 1996;19:687. Abstract.

Cited by

Sorted by citations

See all 156

Related

See all

Metadata

Authors
Stambler, B. S., Wood, M. A., & Ellenbogen, K. A.
Affiliations
Harvard University (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1997-12-16
Volume
96
Issue
12
Pages
4298-4306
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.96.12.4298
OpenAlex
W2060841225
Cited by
156
References
35
Citations by year
2025: 3 · 2024: 3 · 2023: 4 · 2022: 1 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 1 · 2013: 4 · 2012: 6
FWCI
6.57
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords
ibutilide, procainamide, atrial flutter, atrial fibrillation, antiarrhythmic drugs, class III antiarrhythmic agents, monophasic action potential duration, atrial cycle length, intravenous administration
MeSH terms
Adult, Aged, Aged, 80 and over, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Electrophysiology, Female, Humans, Injections, Intravenous, Male, Middle Aged, Procainamide, Sulfonamides, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review