Electrophysiological effects of ibutilide in patients with accessory pathways
Abstract
BACKGROUND: Atrial fibrillation (AF) may cause life-threatening ventricular arrhythmias in patients with Wolff-Parkinson-White syndrome. We prospectively evaluated the effects of ibutilide on the conduction system in patients with accessory pathways (AP). METHODS AND RESULTS: In part I, we gave ibutilide to 22 patients (18 men, 31+/-13 years of age) who had AF during electrophysiology study, including 6 pediatric patients </=18 years of age. Ibutilide terminated AF in 21 of 22 patients (95%) during or 8+/-5 minutes after infusion and prolonged the shortest preexcited R-R interval during AF. Successful ablation was performed in all patients. In part II, ibutilide was given to 18 patients (14 men, 28+/-21 years) to assess its effects on the AP and conduction system. Ibutilide prolonged the antegrade atrioventricular node effective refractory period (ERP) (from 252+/-60 to 303+/-70 ms; P<0.02). Ibutilide caused transient loss of the delta wave in 1 patient and abolished inducible tachycardia in 2 patients, although retrograde mapping still allowed for successful AP ablation. The antegrade AP ERP prolonged from 275+/-40 to 320+/-60 ms (P<0.01), as did the antegrade AP block cycle length; the retrograde AP ERP and block cycle length similarly prolonged with ibutilide. The relative and effective refractory period of the His-Purkinje system increased in 61% of patients after ibutilide. There were no adverse side effects. CONCLUSIONS: We report the use of ibutilide in terminating AP-mediated AF, including the first report in the pediatric population. Ibutilide prolonged refractoriness of the atrioventricular node, His-Purkinje system, and AP.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
In atrial fibrillation, ibutilide, procainamide, propafenone and flecainide act mainly to prevent fast conduction through the accessory pathway.
“In AF, antiarrhythmic drugs as ibutilide, procainamide, propafenone or flecainide, which act mainly to prevent fast conduction through the pathway, are preferable, even if they do not restore sinus rhythm.83,310,311”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [83]
Cites
Ventricular fibrillation in the Wolff-Parkinson-White syndrome
Klein, G. J., Bashore, T. M., Sellers, T. D., Pritchett, E. L. C., Smith, W. M., & Gallagher, J. J. (1979) · New England Journal of Medicine · doi:10.1056/nejm197911153012003 · Cited by 830 · see citing works
Management of Patients With Atrial Fibrillation
Prystowsky, E. N., Benson, D. W., Fuster, V., Hart, R. G., Kay, G. N., Myerburg, R. J., Naccarelli, G. V., & Wyse, D. G. (1996) · Circulation · doi:10.1161/01.cir.93.6.1262 · Cited by 643 · see citing works
Stambler, B. S., Wood, M. A., Ellenbogen, K. A., Perry, K. T., Wakefield, L. K., & VanderLugt, J. T. (1996) · Circulation · doi:10.1161/01.cir.94.7.1613 · Cited by 485 · see citing works
Ellenbogen, K. A., Stambler, B. S., Wood, M. A., Sager, P. T., Wesley, R. C., Meissner, M. D., Zoble, R. G., Wakefield, L. K., Perry, K. T., VanderLugt, J. T., et al. (1996) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(96)00121-0 · Cited by 370 · see citing works
Facilitating Transthoracic Cardioversion of Atrial Fibrillation with Ibutilide Pretreatment
Oral, H., Souza, J. J., Michaud, G. F., Knight, B. P., Goyal, R., Strickberger, S. A., & Morady, F. (1999) · New England Journal of Medicine · doi:10.1056/nejm199906173402401 · Cited by 354 · see citing works
Aborted sudden death in the Wolff-Parkinson-White syndrome
Timmermans, C., Smeets, J. L. R. M., Rodriguez, L.-M., Vrouchos, G., van den Dool, A., & Wellens, H. J. J. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)80136-2 · Cited by 274 · see citing works
Volgman, A. S., Carberry, P. A., Stambler, B., Lewis, W. R., Dunn, G. H., Perry, K. T., VanderLugt, J. T., & Kowey, P. R. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00078-3 · Cited by 242 · see citing works
VanderLugt, J. T., Mattioni, T. A., Denker, S. T., Torchiana, D. F., AHERN, T. S., Wakefield, L. K., Perry, K. T., & Kowey, P. R. (1999) · Circulation · doi:10.1161/01.cir.100.4.369 · Cited by 191 · see citing works
Stambler, B. S., Wood, M. A., & Ellenbogen, K. A. (1997) · Circulation · doi:10.1161/01.cir.96.12.4298 · Cited by 156 · see citing works
Electrophysiologic Effects of Adenosine in Patients With Supraventricular Tachycardia
Glatter, K. A., Cheng, J., Dorostkar, P. C., Modin, G. W., Talwar, S., Alnimri, M., Lee, R. J., Saxon, L. A., Lesh, M. D., & Scheinman, M. M. (1999) · Circulation · doi:10.1161/01.cir.99.8.1034 · Cited by 133 · see citing works
Self-citationComparison of cardiac refractory periods in children and adults.
DuBrow, W., Fisher, E. A. A., Amaty-Leon, G., DENES, P., Wu, D., Rosen, K., & Hastreiter, A. R. (1975) · Circulation · doi:10.1161/01.cir.51.3.485 · Cited by 78 · see citing works
Glatter, K., Yang, Y., Chatterjee, K., Modin, G. W., Cheng, J., Kayser, S., & Scheinman, M. M. (2001) · Circulation · doi:10.1161/01.cir.103.2.253 · Cited by 69 · see citing works
Self-citationDifferential Atrial versus Ventricular Activities of Class III Potassium Channel Blockers
Baskin, E. P., & Lynch, J. (1998) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(24)37375-6 · Cited by 51 · see citing works
Electropharmacologic Effects of Class I and Class III Antiarrhythmia Drugs on Typical Atrial Flutter
Tai, C. T., Chen, S., Feng, A.-N., Yu, W., Chen, Y., & Chang, M.-S. (1998) · Circulation · doi:10.1161/01.cir.97.19.1935 · Cited by 49 · see citing works
Sato, N., Tanaka, H., Habuchi, Y., et al. (2000) · European Journal of Pharmacology · doi:10.1016/s0014-2999(00)00603-8 · Cited by 32 · see citing works
Ibutilide for Termination of Atrial Fibrillation in the Wolff‐Parkinson‐White Syndrome
Varriale, P., Sedighi, A., & MIRZAIETEHRANE, M. (1999) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1999.tb00614.x · Cited by 14 · see citing works
Part 6: Advanced Cardiovascular Life Support
(2000) · Circulation · doi:10.1161/circ.102.suppl_1.i-86 · Cited by 5 · see citing works
The Effect of Ibutilide on Retrograde Accessory Pathway Conduction
Sorbera, C. A., & Cohen, M. I. (2000) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2000.tb00803.x · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Blomstrom-Lundqvist (2003) · doi:10.1161/01.cir.0000091380.04100.84 · Cited by 955 · see citing works
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933 · see citing works
2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia
Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A. M., Field, M. E., Goldberger, Z. D., Hammill, S. C., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.08.856 · Cited by 439 · see citing works
Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
Safety and efficacy of ibutilide in cardioversion of atrial flutter and fibrillation
Nair, M., George, L. K., & Koshy, S. K. G. (2011) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2011.01.080096 · Cited by 44 · see citing works
- Authors
- Glatter, K. A., Dorostkar, P. C., Yang, Y., Lee, R. J., Van Hare, G. F., Keung, E., Modin, G., & Scheinman, M. M.
- Affiliations
- San Francisco VA Medical Center (US)
- From the Cardiovascular Research Institute and Section of Adult and Pediatric Cardiac Electrophysiology, University of California, San Francisco; and San Francisco Veterans Administration Medical Center (E.K.).
- Venue
- Circulation
- Published
- 2001-10-16
- Volume
- 104
- Issue
- 16
- Pages
- 1933-1939
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1995037447
- Cited by
- 86
- References
- 18
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 8 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 2.68
- 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, accessory pathway, Wolff-Parkinson-White syndrome, atrial fibrillation, atrioventricular node refractory period, accessory pathway refractory period, delta oscillations, pediatric patients, catheter ablation, ventricular arrhythmias
- MeSH terms
- Adolescent, Adult, Anti-Arrhythmia Agents, Atrial Fibrillation, Cardiac Pacing, Artificial, Child, Child, Preschool, Electrocardiography, Female, Cardiac Catheterization, Heart Conduction System, Humans, Infusions, Intravenous, Male, Middle Aged, Prospective Studies, Sulfonamides, Wolff-Parkinson-White Syndrome, Treatment Outcome, Electrophysiologic Techniques, Cardiac
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
