Clinical Comparison of Ibutilide and Propafenone for Converting Atrial Flutter

Abstract

Ibutilide is highly effective for rapidly terminating atrial flutter. This new class III drug, under monitored conditions, is a potential alternative to currently available cardioversion options.

Conversion efficacy of intravenous ibutilide compared with intravenous amiodarone in patients with recent-onset atrial fibrillation and atrial flutter

“…The mean time to arrhythmia termination was 10-23 min. In other studies, ibutilide was superior to propafenone for treating Af (90% vs. 30%, p b 0.01) [16] and AF (70.73% vs. 48.78%) [17]. In a comparison study, ibutilide was found superior than Sotalol in terminating Af (70% vs. 56%) and AF (44% vs. 11%) [18].…”

The characteristics of pre‐excitation syndrome concomitant with atrial tachyarrhythmia and the effect of radiofrequency ablation

“…The main reason might be as follows: (1) Class Ic drugs can decrease TCL without converting flutter. A previous study showed that there was a significant lengthening of the AFL cycle (194 ± 32 ms vs. 268 ± 42 ms) 11 from before to after drug usage; (2) class Ic drugs might lengthen the effective refractory period of the AP; (3) the depression of the AVN could decrease the anterograde conduction over the AVN, which might increase the anterograde conduction over the AP; (4) the match between AP effective refractory period and TCL might lead to 1:1 conduction. Hence, we recommend avoiding the use of propafenone injection in patients with ATA concomitant with anterograde conduction of a bystander AP.…”