The Effect Of Ibutilide Injection On Cardioversion Of Atrial Fibrillation And Atrial Flutter

Objective To evaluate the efficacy and safety of ibutilide for cardioversion of atrial fibrillation and atrial flutter.Methods Twenty-six consecutive patients aged 18 ～ 70 years with AF/AFL were included. The duration of arrhythmia was less than 90 days ranged from 3 hours to 50 days , and ventricular rate (VR) was more than 60 beats/min. Ibutilide was given by injection. Patients received ibutilide 1mg if bodyweight=60kg or 0.01 mg/kg if bodyweight<60kg; treatment was repeated if atrial fibrillation or flutter was not converted after 10 min of the first dosage. The HR,Bp,ECG and QTc were recordedResults 12 patients were successfully restored sinus rhythm in 90min after ibutilide injection while the other 14 ones failed. The QTc interval gradually prolonged. The average QTc interval was prolonged from 0.403s to 0.461s. The heart rate was reduced from 124beats/min to 98beats/min after the first injection. During the period of treatment, blood pressure appeared no difference. Eight patients appeared PVCsand two of them were non-sustained monomorphic ventricular tachycardia . Sinus arrest occurred in two patients with sick sinus syndrome. No torsade de pointes was observed.Conclusions Ibutilide can be used in conversion of atrial fibrillation and atrial flutter safely and effically. The proarrhythmic effect of ibutilide should be carefully aware of, especially to those with high risk patients...