Efficacy and Safety of Ibutilide for the Conversion of Monomorphic Atrial Tachycardia

Eidher, U.; F, Freihoff; Kaltenbrunner, W; Steinbach, K.

doi:10.1111/j.1540-8159.2006.00353.x

Cited by 18 publications

(5 citation statements)

References 14 publications

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“…However, atrial flutter was not sub-classified into TAF and AAF in any of these reports [2,4,5,20]. The only study on ibutilide treatment in patients with regular atrial arrhythmias apart from TAF supports our results by reporting a lower conversion rate (39%) [21] than those found for the entity of patients with atrial flutter in several trials before [2,4,20].…”

Section: Conversion Rates By Initial Arrhythmiasupporting

confidence: 91%

Pre-injection of magnesium sulfate enhances the efficacy of ibutilide for the conversion of typical but not of atypical persistent atrial flutter

Steinwender

Hönig

Kypta

et al. 2010

International Journal of Cardiology

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Section: Conversion Rates By Initial Arrhythmiasupporting

confidence: 91%

Pre-injection of magnesium sulfate enhances the efficacy of ibutilide for the conversion of typical but not of atypical persistent atrial flutter

Steinwender

Hönig

Kypta

et al. 2010

International Journal of Cardiology

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“…In this subgroup, amiodarone was associated with a 100% success rate, but no further details on the arrhythmia mechanisms were presented. For ibutilide, the guidelines cite a single prospective, open-labelled trial evaluating ibutilide in 49 patients with fAT and atypical AFL, which was published in 2006 by Eidher et al [ 24 ]. The overall success rate was 39%, and the subgroup-specific success rates were not reported in detail.…”

Section: Discussionmentioning

confidence: 99%

Cardioversion of Post-Ablation Atrial Tachyarrhythmia with Ibutilide and Amiodarone: A Registry-Based Cohort Study

Cacioppo

Schwameis

Schuetz

et al. 2022

IJERPH

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Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the cardioversion success of ibutilide and amiodarone in patients with post-ablation atrial tachyarrhythmia. We included all episodes of post-ablation atrial tachyarrhythmia in patients treated with either intravenous ibutilide or amiodarone at an academic emergency department from 2010 to 2018. The primary endpoint was the conversion to sinus rhythm. The conversion rates were stratified by arrhythmia type, and multivariable cluster-adjusted logistic regression was used to estimate the effect of ibutilide and amiodarone on cardioversion success, given as the odds ratio (OR) with 95% confidence intervals (95% CI). In total, 109 episodes of 72 patients were analyzed. The conversion rates were 37/49 (76%) for ibutilide and 16/60 (27%) for amiodarone. Compared to amiodarone, ibutilide was associated with higher odds of conversion (multivariable cluster-adjusted OR 5.6, 95% CI 1.3–24.3). The cardioversion success of ibutilide was the highest in atrial flutter (crude OR 19.5, 95% CI 3.4–112.5) and focal atrial tachycardia (crude OR 8.3, 95% CI 1.5–47.2), but it was less pronounced in atrial fibrillation (crude OR 4.5, 95% CI 1.2–17.2). Randomized trials are warranted to confirm our findings.

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“…It has been suggested that in critically ill patients recent-onset AF should only be treated with IV amiodarone if it is absolutely necessary, and the duration of therapy should not exceed 24-48 h [19]. Ibutilide causes a high risk of torsades de pointes (≥4%) [2,19,20,21,22]. Sotalol may also cause excessive QT prolongation and torsades de pointes, but less frequently than ibutilide [2].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Intravenous and Oral Sotalol in Pharmacologic Conversion of Atrial Fibrillation: A Systematic Review and Meta-Analysis

et al. 2016

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Objectives: The role of sotalol is well established for the maintenance of sinus rhythm after successful conversion of atrial fibrillation (AF). However, its role in pharmacologic conversion of AF is poorly defined. The purpose of this study is to compare the efficacy of sotalol to that of other antiarrhythmic agents for AF conversion. Methods: Standard methods of meta-analysis were employed. Full-text publications of clinical trials in English that compared the efficacy of sotalol to that of other antiarrhythmics or placebo/no treatment were eligible for inclusion. Results: A systematic review revealed 10 eligible publications. Sotalol was superior to placebo and/or no antiarrhythmic therapy in AF conversion, with a relative success of 24 (95% CI 4.7-119, p < 0.001). Sotalol was not significantly different from class IA antiarrhythmic drugs. Similarly, sotalol was not different from class IC antiarrhythmic drugs or amiodarone in terms of conversion efficacy. In one study, sotalol was less effective than high-dose ibutilide (2 mg), with a relative success of 0.248 (95% CI 0.128-0.481, p < 0.001). Ibutilide caused more proarrhythmia. Conclusions: Sotalol is as effective as class IA and class IC antiarrhythmic agents, and it is also as effective as amiodarone for pharmacologic conversion of AF. Only ibutilide at a high dose showed a greater conversion rate of AF.

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Efficacy and Safety of Ibutilide for the Conversion of Monomorphic Atrial Tachycardia

Abstract: 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.

Cited by 18 publications

References 14 publications

Pre-injection of magnesium sulfate enhances the efficacy of ibutilide for the conversion of typical but not of atypical persistent atrial flutter

Pre-injection of magnesium sulfate enhances the efficacy of ibutilide for the conversion of typical but not of atypical persistent atrial flutter

Cardioversion of Post-Ablation Atrial Tachyarrhythmia with Ibutilide and Amiodarone: A Registry-Based Cohort Study

Efficacy of Intravenous and Oral Sotalol in Pharmacologic Conversion of Atrial Fibrillation: A Systematic Review and Meta-Analysis

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