Safety and efficacy of ibutilide in cardioversion of atrial flutter and fibrillation

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

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 fi-brillation 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.

Original languageEnglish (US)
Pages (from-to)86-92
Number of pages7
JournalJournal of the American Board of Family Medicine
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2011

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Electric Countershock
Atrial Flutter
Atrial Fibrillation
Safety
Torsades de Pointes
Amiodarone
Ventricular Tachycardia
ibutilide
Thoracic Surgery
Intensive Care Units
Shock
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Family Practice
  • Public Health, Environmental and Occupational Health

Cite this

Safety and efficacy of ibutilide in cardioversion of atrial flutter and fibrillation. / Nair, Madhuri; George, Lekha; Koshy, Santhosh.

In: Journal of the American Board of Family Medicine, Vol. 24, No. 1, 01.01.2011, p. 86-92.

Research output: Contribution to journalReview article

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