Document Detail


Efficacy and safety of ibutilide for the conversion of monomorphic atrial tachycardia.
MedLine Citation:
PMID:  16650262     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ibutilide is a class III antiarrhythmic drug, frequently used for conversion of atrial fibrillation and flutter. We studied the efficacy of ibutilide for acute conversion of monomorphic atrial tachycardia (monoAT) in a prospective, open label study in the intensive care unit of a cardiological clinic. METHODS: We examined 49 episodes of monoAT in 38 patients (19 men/19 women). Thirty-three patients (87%) suffered from structural heart disease. Twenty-three episodes occurred while on antiarrhythmic therapy with class I or III drugs. Patients with prolonged QT interval (except for patients with pretreatment with class III drugs), hypokalemia, left ventricular failure, and recent myocardial infarction were excluded. All patients received one or two doses of 1 mg ibutilide fumarate under continuous rhythm monitoring. RESULTS: Conversion to sinus rhythm occurred in 19 episodes (38.8%), in 6 episodes (12.2%) after the first dose. Conversion rate was significantly higher in patients with a short history of symptoms (66.6% vs 28.6%; P < 0.05), of documented arrhythmia (0.13 (0/5.7) vs 2.6 (0.38/23.5) months, median (interquartile range); P < 0.03), higher atrial rate (272 +/- 49 vs 207 +/- 36 beats/min (means +/- SD); P < 0.004), or without preexisting antiarrhythmic therapy (53.8% vs 21.7%; P < 0.02). No differences in conversion rates were found regarding gender, age, body mass index, left ventricular function, left atrial diameter, or underlying disease. In three episodes torsade de pointes occurred after ibutilide (6.1%), requiring defibrillation in two cases (4.1%). CONCLUSIONS: Ibutilide can be used for conversion of monoAT with a similar efficacy as for atrial fibrillation, but with a considerably lower efficacy compared to typical atrial flutter.
Authors:
Ulrike Eidher; Fritz Freihoff; Wilhelm Kaltenbrunner; Konrad Steinbach
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  29     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-05-02     Completed Date:  2006-09-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  358-62     Citation Subset:  IM    
Affiliation:
Ludwig-Boltzmann Institute for Arrhythmia Research, Department of Internal Medicine 3 (Cardiology), Wilhelminenspital, Vienna, Austria. dr_eidher@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / administration & dosage,  adverse effects
Female
Humans
Male
Middle Aged
Risk Assessment
Risk Factors
Sulfonamides / administration & dosage*,  adverse effects*
Tachycardia, Ectopic Atrial / diagnosis*,  drug therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Sulfonamides; 130350-52-6/ibutilide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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