Conversion of recent-onset atrial fibrillation or flutter with ibutilide after amiodarone has failed

To evaluate whether ibutilide can convert atrial fibrillation or flutter in patients in whom amiodarone has failed. Clinical study in a university hospital intensive care unit (ICU). Twenty-six patients were studied, in whom atrial fibrillation or flutter persisted for a maximum of 6 h at maximum. P...

Full description

Saved in:
Bibliographic Details
Published in:Intensive care medicine 2002-07, Vol.28 (7), p.925-929
Main Authors: HENNERSDORF, Marcus G, PERINGS, Stefan M, ZÜHLKE, Christian, HEIDLAND, Ulrich E, PERINGS, Christian, HEINTZEN, Matthias P, STRAUER, Bodo E
Format: Article
Language:English
Subjects:
Aged
Amiodarone - administration & dosage
Amiodarone - therapeutic use
Anti-Arrhythmia Agents - administration & dosage
Anti-Arrhythmia Agents - therapeutic use
Antiarythmic agents
Atrial Fibrillation - drug therapy
Atrial Fibrillation - physiopathology
Atrial Fibrillation - therapy
Atrial Flutter - drug therapy
Atrial Flutter - physiopathology
Atrial Flutter - therapy
Biological and medical sciences
Cardiovascular system
Critical Care - methods
Electric Countershock
Electrocardiography
Germany
Humans
Intensive Care Units
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Sulfonamides - administration & dosage
Sulfonamides - therapeutic use
Treatment Outcome
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To evaluate whether ibutilide can convert atrial fibrillation or flutter in patients in whom amiodarone has failed. Clinical study in a university hospital intensive care unit (ICU). Twenty-six patients were studied, in whom atrial fibrillation or flutter persisted for a maximum of 6 h at maximum. Patients were monitored continuously during the arrhythmia. Medical conversion was necessary due to symptomatic or hemodynamic causes. All patients initially received amiodarone (150 mg i.v.) and after 2 h of persistent arrhythmia ibutilide (1 mg or, without success and body weight > 70 kg, 2 mg i.v.). Before the administration of ibutilide 1 g magnesium was administered, and high normal levels of potassium serum levels were achieved (4.5-5.0 mmol/l). RESULTS. After amiodarone atrial flutter persisted in 73% and atrial fibrillation in 27% of patients. After ibutilide the QT interval was prolonged from 327 +/- 61 to 387 +/- 62 ms. The QTc interval increased from 456 +/-32 to 461 +/- 66 ms. Conversion to normal sinus rhythm was achieved in 22 of 27 of cases. Nonsustained torsade de pointes tachycardia was seen in three patients (11%). No patient showed sustained ventricular tachycardia. Patients with proarrhythmic effects were characterized by a decreased left ventricular function. In ICU patients ibutilide led to conversion to sinus rhythm in 81.5% of patients in whom amiodarone was unsuccessful. Nonsustained tachycardias were seen in 11%; sustained ventricular tachycardia was not seen. Ibutilide seems to be well suitable for conversion of recent onset atrial fibrillation or flutter and had no severe side effects in this study population.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-002-1317-3