Facilitating Transthoracic Cardioversion of Atrial Fibrillation with Ibutilide Pretreatment

Oral, Hakan; Souza, Joseph J.; Michaud, Gregory F.; Knight, Bradley P.; Goyal, Rajiva; Strickberger, S. Adam; Morady, Fred

doi:10.1056/nejm199906173402401

Cited by 332 publications

(167 citation statements)

References 35 publications

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“…Wcześniejsze podanie amiodaronu (wymagające kilku tygodni leczenia) [631,632], sotalolu [631], ibutilidu [633] lub wernakalantu [634] może zwiększyć skuteczność kardiowersji elektrycznej, a podobny efekt występuje prawdopodobnie w przypadku podania flekainidu [584] lub propafenonu [635]. Nie ma wiarygodnych danych, które wskazywałyby, że beta-adrenolityki [636], werapamil, diltiazem [637][638][639] oraz digoksyna [640,641] są skuteczne jako leki przerywające AF lub ułatwiające kardiowersję elektryczną.…”

Section: Kardiowersja Elektrycznaunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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Section: Kardiowersja Elektrycznaunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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“…Ibutilide significantly facilitates cardioversion of atrial fibrillation with standard monophasic transthoracic defibrillation. 3 There was a 100% conversion rate in patients receiving pretreatment with ibutilide compared with 72% in patients receiving no pretreatment. In pretreated patients, transthoracic electrical cardioversion was performed 10 minutes after completion of infusion of 1 mg of ibutilide given intravenously over 10 minutes.…”

Section: Use Of Ibutilide In Persistent Atrial Fibrillation and Fluttermentioning

confidence: 98%

“…The energy requirement for defibrillation after pretreatment was significantly reduced (166 Ϯ 80 Joules vs 228 Ϯ 93 Joules). 3 Ibutilide pretreatment preceding biphasic shock defibrillation improves the efficacy of cardioversion by reducing the number of attempts and the energy requirement, thereby lowering the risk of muscle damage. 2 Ibutilide has a greater efficacy in conversion of atrial flutter compared with atrial fibrillation, especially in patients with recent-onset arrhythmia.…”

Section: Use Of Ibutilide In Persistent Atrial Fibrillation and Fluttermentioning

confidence: 99%

“…Chemical cardioversion is less invasive, more cost-effective, and, unlike electrical cardioversion, it does not require sedation. [2][3][4] The various drugs commonly used for pharmacologic cardioversion are ibutilide, procainamide, propafenone, flecanide, amiodarone, and dofetilide. Among these drugs, ibutilide, dofetilide, flecanide, and propafenone have class I (level of evidence A) indication for their use in pharmacologic cardioversion of atrial fibrillation.…”

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confidence: 99%

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Safety and Efficacy of Ibutilide in Cardioversion of Atrial Flutter and Fibrillation

Nair¹,

George²,

Koshy

2011

The Journal of the American Board of Family Medicine

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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. In selected patient populations, cardioversion still remains the preferred management for atrial fibrillation and flutter, even though data suggest no survival advantage for rhythm control over rate control.1 Electrical cardioversion has been the most widely used and the most effective method to restore sinus rhythm in these atrial arrhythmias. However, chemical cardioversion is a good alternative for use in certain patient groups. Chemical cardioversion is less invasive, more cost-effective, and, unlike electrical cardioversion, it does not require sedation. Ibutilide-despite its efficacy, which is comparable or superior to other agents-is not widely used, mainly because of physician's lack of awareness about its safety and efficacy profile. This article reviews the safety and efficacy data of ibutilide and also compares it with other antiarrhythmics used for atrial fibrillation and flutter.Ibutilide, a class III antiarrhythmic drug that was approved by the Food and Drug Administration for This article was externally peer reviewed.

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“…Randomized studies show that previous use of antiarrhythmic drugs enhances the efficacy of electrical cardioversion or, at least, decreases early recurrence of atrial fibrillation [12][13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

Initial Energy for External Electrical Cardioversion of Atrial Fibrillation

Figueiredo¹,

Veloso²,

Paola³

2002

Arq. Bras. Cardiol.

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Facilitating Transthoracic Cardioversion of Atrial Fibrillation with Ibutilide Pretreatment

Abstract: The efficacy of transthoracic cardioversion for converting atrial fibrillation to sinus rhythm was enhanced by pretreatment with ibutilide. However, use of this drug should be avoided in patients with very low ejection fractions.

Cited by 332 publications

References 35 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Safety and Efficacy of Ibutilide in Cardioversion of Atrial Flutter and Fibrillation

Initial Energy for External Electrical Cardioversion of Atrial Fibrillation

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