Conversion Efficacy and Safety of Intravenous Ibutilide Compared With Intravenous Procainamide in Patients With Atrial Flutter or Fibrillation 11This study was sponsored by Pharmacia &amp; Upjohn, Kalamazoo, Michigan.22See Appendix Afor a complete list of investigators and study sites.

Volgman, Annabelle Santos; Carberry, Peter A.; Stambler, Bruce S.; Lewis, William R.; Dunn, George H.; Perry, Kimberly T.; VanderLugt, James T.; Kowey, Peter R.

doi:10.1016/s0735-1097(98)00078-3

Cited by 218 publications

(16 citation statements)

References 12 publications

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“…Pharmacological cardioversion can be used as followed: IV ibutilide is an effective drug available to covert AF, 1 mg over 10 minutes while observing for QTc prolongation and ventricular proarrhythmia. Dose can be repeated after 10 minutes, but the risk of proarrhythmia increases [16][17][18]; or IV amiodarone loading dose 150 mg over 10 minutes + IV maintenance dose 0.5 -1 mg/min. It is an appropriate initial choice in patients with left ventricular hypertrophy (LVH), HF, or coronary heart disease (CHD), because it is associated with a low risk of proarrhythmia.…”

Section: Restoration Of Sinus Rhythmmentioning

confidence: 99%

Contemporary therapy of atrial fibrillation

Yang¹,

Sun²,

Yu³

2012

WJCD

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Atrial fibrillation (AF) is estimated that by 2010, approximately 2.6 million people will be affected in USA; by 2050, that number may increase to 10 million patients. Generally, rate control alone is reasonable in some AF patients, especially asymptomatic patients. Restoration and maintenance of sinus rhythm (SR) may be achieved by means of cardioversion, drugs or/ and catheter ablation. Pharmacological therapy can be useful to maintain SR and prevent tachycardia-induced cardiomyopathy. All patients with AF regardless of whether a rhythm or rate control strategy recommend anticoagulant, antiplatelet or both combined therapy for prevention of thromboembolism, except those with lone AF or contraindications. Drug selection should be based upon the absolute risk of stroke, bleeding, the relative risk and benefit for a given patient. Biventricular pacing may overcome many of the adverse hemodynamic effects associated with RV pacing alone. A target individual ectopic foci ablation within the pulmonary vein (PV) has evolved to circumferential electrical isolation of the entire PV musculature. Cavotricuspid isthmus should be considered as first-line therapy for patients with typical atrial flutter. Completely non-fluoroscopic ablation guided by Real-Time Magnetic Resonance Imaging (RTMRI) using a steerable and non-ferromagnetic catheter is a promising novel technology in interventional electrophysiology

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Section: Restoration Of Sinus Rhythmmentioning

confidence: 99%

Contemporary therapy of atrial fibrillation

Yang¹,

Sun²,

Yu³

2012

WJCD

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“…[1819] For those who responded to ibutilide, the mean time interval to conversion was 30 min; the efficacy of intravenous ibutilide (76%) was significantly higher than that of intravenous procainamide (14%). [20] Several single-blinded, randomized control trials comparing intravenous flecainide with either intravenous propafenone or intravenous verapamil have shown relatively poor efficacy for acute conversion (5-13%); in addition, the conversion rate of intravenous sotalol varied from 20-40% depending on the sotalol dose, but was not different from placebo. High dose (2 mg) of ibutilide was more effective than sotalol (1.5 mg/kg) in conversion of patients with Aflut to sinus rhythm (70 versus 19%).…”

Section: Atrial Fluttermentioning

confidence: 99%

Treating critical supraventricular and ventricular arrhythmias

Trappe¹

2010

J Emerg Trauma Shock

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Atrial fibrillation (AF), atrial flutter, AV-nodal reentry tachycardia with rapid ventricular response, atrial ectopic tachycardia and preexcitation syndromes combined with AF or ventricular tachyarrhythmias (VTA) are typical arrhythmias in intensive care patients (pts). Most frequently, the diagnosis of the underlying arrhythmia is possible from the physical examination (PE), the response to maneuvers or drugs and the 12-lead surface electrocardiogram. In unstable hemodynamics, immediate DC-cardioversion is indicated. Conversion of AF to sinus rhythm (SR) is possible using antiarrhythmic drugs. Amiodarone has a conversion rate in AF of up to 80%. Ibutilide represents a class III antiarrhythmic agent that has been reported to have conversion rates of 50-70%. Acute therapy of atrial flutter (Aflut) in intensive care pts depends on the clinical presentation. Atrial flutter can most often be successfully cardioverted to SR with DC-energies <50 joules. Ibutilide trials showed efficacy rates of 38-76% for conversion of Aflut to SR compared to conversion rates of 5-13% when intravenous flecainide, propafenone or verapamil was administered. In addition, high dose (2 mg) of ibutilide was more effective than sotalol (1.5 mg/kg) in conversion of Aflut to SR (70 versus 19%). Drugs like procainamide, sotalol, amiodarone or magnesium were recommended for treatment of VTA in intensive care pts. However, only amiodarone is today the drug of choice in VTA pts and also highly effective even in pts with defibrillation-resistant out-of-hospital cardiac arrest (CA). There is a general agreement that bystander first aid, defibrillation and advanced life support is essential for neurologic outcome in pts after cardiac arrest due to VTA. Public access defibrillation in the hands of trained laypersons seems to be an ideal approach in the treatment of ventricular fibrillation (VF). The use of automatic external defibrillators (AEDs) by basic life support ambulance providers or first responder (FR) in early defibrillation programs has been associated with a significant increase in survival rates (SRs). However, use of AEDs at home cannot be recommended.

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“…Not surprisingly, a high rate of conversion was seen not only with propafenone plus digoxin (89%) and quinidine plus digoxin (84%) but also with placebo (77%) at 24 hours. In studies (which have appeared in abstract form) that directly compare the efficacy of ibutilide to other therapies, the drug was found to be superior to intravenous administration of either sotalol or procainamide in terminating AF and atrial flutter [77,83,84].…”

Section: Ibutilidementioning

confidence: 99%

Pharmacological Treatment of Atrial Fibrillation: Mechanisms of Action and Efficacy of Class III Drugs

Lombardi¹,

Terranova

2006

CMC

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Atrial fibrillation represents a major clinical, social and economical matter, and its importance is expected to increase even more in the near future. The progressive ageing of population is associated with an inevitable rising in incidence and prevalence of this rhythm disorder, which limits functional capability, favours occurrence of cerebrovascular events and increases people's request for emergency room visits and hospital recovery. In spite of the increasing successes of the interventional non-pharmacological therapies, drug treatment of patients with atrial fibrillation in relation to conversion to sinus rhythm and prevention of recurrences, maintains a critical role. Several antiarrhythmic drugs are nowadays available, but their efficacy is limited by the high rate of arrhythmias recurrences and by side effects during acute and chronic treatment. Drugs interfering with potassium channels (Class III drugs) have been proposed and used in patients with atrial fibrillation. Aim of this review is to discuss the most recent data on the efficacy and feasibility of class III drugs in atrial fibrillation. Experimental and clinical data on dronedarone, ibutilide, dofetilide, azimilide, ersentilide and ambasilide will be hereby discussed.

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Conversion Efficacy and Safety of Intravenous Ibutilide Compared With Intravenous Procainamide in Patients With Atrial Flutter or Fibrillation 11This study was sponsored by Pharmacia & Upjohn, Kalamazoo, Michigan.22See Appendix Afor a complete list of investigators and study sites.

Cited by 218 publications

References 12 publications

Contemporary therapy of atrial fibrillation

Contemporary therapy of atrial fibrillation

Treating critical supraventricular and ventricular arrhythmias

Pharmacological Treatment of Atrial Fibrillation: Mechanisms of Action and Efficacy of Class III Drugs

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