Cited by 44Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmias

Safety and efficacy of ibutilide in cardioversion of atrial flutter and fibrillation

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Nair, M., George, L. K., Koshy, S. K. G.·2011·The Journal of the American Board of Family Medicine

Abstract

This article reviews the safety and efficacy of ibutilide for use in patients with atrial fibrillation and flutter. Ibutilide, a class III antiarrhythmic agent, is primarily used for conversion of atrial flutter and fibrillation and is a good alternative to electrical cardioversion. Ibutilide has a conversion rate of up to 75% to 80% in recent-onset atrial fibrillation and flutter; the conversion rate is higher for atrial flutter than for atrial fibrillation. It is also safe in the conversion of chronic atrial fibrillation/flutter among patients receiving oral amiodarone therapy. Ibutilide pretreatment facilitates transthoracic defibrillation and decreases the energy requirement of electrical cardioversion by both monophasic and biphasic shocks. Pretreatment with ibutilide before electrical defibrillation has a conversion rate of 100% compared with 72% with no pretreatment. Ibutilide is also safe and efficient in the treatment of atrial fibrillation in patients who have had cardiac surgery, and in accessory pathway-mediated atrial fibrillation Where the conversion rate of ibutilide is as high as 95%. There is up to a 4% risk of torsade de pointes and a 4.9% risk of monomorphic ventricular tachycardia. Hence, close monitoring in an intensive care unit setting is warranted during and at least for 4 hours after drug infusion. The anticoagulation strategy is the same as for any other mode of cardioversion.

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Crossref · 10.3122/jabfm.2011.01.080096

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Research works printed but not linked: 5

  1. Oral H, Souza JJ, Michaud GF, et al. Facilitating trans- thoracic cardioversion of atrial fibrillation with Ibutil- ide pretreatment. N Engl J Med 1999;340:1849 -54.
  2. Glatter KA, Dorostkar PC, Yang Y, et al. Electro- physiological effects of ibutilide in patients with ac- cessory pathways. Circulation 2001;104:1933-9.
  3. Volgman AS, Carberry PA, Stambler B, et al. Con- version efficacy and safety of intravenous ibutilide compared with intravenous procainamide in patients with atrial flutter or fibrillation. J Am Coll Cardiol 1998;31:1414 -9.
  4. Rodriguez EV, Rodriguez CC, Estrada SA, Rojo JR, Morales EH, Munoz AU. Pharmacological cardio- version with intravenous propafenone in atrial fibril- lation. Arch Inst Cardiol Mex 2000;70:160 -6.
  5. Kochiadakis GE, Igoumenidis NE, Parthenakis FI, Chlouverakis GI, Vardas PE. Amiodarone versus propafenone for conversion of chronic atrial fibril- lation: results of randomized, controlled study. J Am Coll Cardiol 1999;33:966 -71.

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Authors
Nair, M., George, L. K., & Koshy, S. K. G.
Affiliations
  • University of Oklahoma - Tulsa (US)
  • University of Tennessee Health Science Center (US)
Venue
The Journal of the American Board of Family Medicine
Published
2011-01-01
Volume
24
Issue
1
Pages
86-92
ISSN
  • 1557-2625 (ISSN-L)
  • 1558-7118
OpenAlex
W2143440359
Cited by
44
References
63
Citations by year
2025: 1 · 2024: 5 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 2
FWCI
0.54
Type
journal article
Language
en
Open access
Locations
  • The Journal of the American Board of Family Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords
ibutilide, atrial fibrillation, atrial flutter, electrical cardioversion, antiarrhythmic drugs, class III antiarrhythmic agents, amiodarone, transthoracic defibrillation, postoperative atrial fibrillation, torsades de pointes, monomorphic ventricular tachycardia, drug safety, conversion rate
MeSH terms
Age Factors, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Chronic Disease, Humans, Long QT Syndrome, Postoperative Period, Sulfonamides, Drug-Related Side Effects and Adverse Reactions

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